Case-Control Study Of Topography-Guided Photorefractive Keratectomy And Corneal Crosslinking Between Patients With Progressive And Stable Keratoconus
Published 2024 - 42nd Congress of the ESCRS
Reference: PO678 | Type: Free paper | DOI: 10.82333/2yqa-vg44
Authors: Pedro Gil 1 , João Quadrado Gil* 2 , Margarida Dias 3 , Bruna Cunha 4 , Nuno Alves 4 , Andreia Rosa 2 , Joaquim Murta 2
1Unidade Local de Saúde de São José,Lisbon,Portugal;University of Coimbra, Faculty of Medicine,Coimbra,Portugal, 2Ophthalmology Department,Unidade Local de Saúde de Coimbra,Coimbra,Portugal;University of Coimbra, Faculty of Medicine,Coimbra,Portugal;Clinical Academic Center of Coimbra,Coimbra,Portugal, 3Ophthalmology Department,Unidade Local de Saúde de Coimbra,Coimbra,Portugal;Clinical Academic Center of Coimbra,Coimbra,Portugal, 4Ophthalmology Department,Unidade Local de Saúde de São José,Lisbon,Portugal
Purpose
To conduct a comparative analysis of the visual, refractive and tomographic outcomes of combined topography-guided photorefractive keratectomy (TG-PRK) and corneal crosslinking (CXL) between patients with progressive and stable keratoconus.
Setting
Department of Ophthalmology, Coimbra Local Health Unit, Coimbra, Portugal; Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
Methods
Longitudinal retrospective case-control study. Keratoconus patients who underwent TG-PRK combined with CXL were included, with a follow-up period ranging from a minimum of 12 months up to 3 years. Patients were categorized as either progressive or stable based on predetermined criteria for disease progression.
Results
The study included 101 eyes of 93 patients, 62 cases progressive and 39 stable keratoconus. Groups were similar, except for younger age in progressive (p<0.001). logMAR CDVA improved in progressive (baseline: 0.48±0.24; 12months: 0.33±0.29; p<0.001) and stable (baseline: 0.51±0.24; 12months: 0.28±0.21; p<0.001) patients. Maximum keratometry decreased in progressive (baseline: 59.18±5.63; 12months: 54.73±5.95; p<0.001) and stable (baseline: 57.77±5.02; 12months: 53.59±4.20; p<0.001). Index of surface variance improved in progressive (baseline: 109.18±31.74 diopters; 12months: 94.11±34.11; p<0.001) and stable (baseline: 102.87±29.52; 12months: 86.95±27.21; p<0.001). There were no differences between groups in these outcomes.
Conclusions
Combined TG-PRK and CXL is a safe and effective procedure allowing for marked improvement in terms of visual outcomes and corneal regularization. Visual, refractive and tomographic outcomes are similar between patients with progressive and stable keratoconus. Combined TG-PRK and CXL is a valid therapeutic strategy for visual rehabilitation in stable keratoconus patients.