ESCRS - PP26.11 - Comparing The Approach Of Two Different Excimer Laser Platforms In The Treatment Of Keratoconus Followed By Accelerated Corneal Cross-Linking (Cxl)

Comparing The Approach Of Two Different Excimer Laser Platforms In The Treatment Of Keratoconus Followed By Accelerated Corneal Cross-Linking (Cxl)

Published 2024 - 42nd Congress of the ESCRS

Reference: PP26.11 | Type: Free paper | DOI: 10.82333/dy0j-qb08

Authors: Costas H. Karabatsas 1 , Minas Aslanidis* 2 , Samuel Arba Mosquera 3 , Ioannis Aslanides 4 , Vasileios Selimis 4 , Charalambos Koulas 5 , Achyut Mukherjee 6

1Attico Ophthalmologiko Eye Center,Athens,Greece;Biomedical Sciences, Optics & Optometry Section, University of West Attica (UNIWA),Athens,Greece, 2Ophthalmology, East Suffolk and North Essex NHS Foundation Trust,Colchester,United Kingdom, 3SCHWIND eye-tech-solutions GmbH,Kleinostheim ,Germany, 4Emmetropia Eye Institute,Heraklion,Greece, 5Attico Ophthalmologiko Eye Center,Athens,Greece, 6Colchester Eye Centre & ICENI Centre,Colchester,United Kingdom

Purpose

To analyse and compare visual, refractive and topographic outcomes of combining All Surface Laser Ablation (ASLA/TransPRK) or customized transepithelial no-touch (cTEN) with simultaneous corneal crosslinking for the visual rehabilitation of contact lens intolerant keratoconus patients; among patients treated with 2 different laser platforms and 2 different customization levels.

Setting

Emmetropia Eye Institute, Heraklion, Crete, Greece and Attico Ophthalmologiko Eye Center, Athens, Greece

Methods

Patients with topographically significant keratoconus (Grade I & II according to Amsler-Krumeich classification), limited corrected vision and intolerant of contact lenses were retrospectively reviewed. All patients had undergone single step ASLA and sequential crosslinking with one of the laser systems (SCHWIND AMARIS or iVIS iRES) and one of the customization levels (corneal wavefront guided for AMARIS or CTEN for iRES). Preoperative vision, refraction, corneal topography and wavefront were assessed, with postoperative assessment at 1, 3, 6, and 12 months.

Results

27 eyes were included in the retrospective chart review. Mean age was 30 years (SD 6, range 20 to 41). Mean preoperative best corrected vision was 0.3 LogMAR (SD 0.2). Mean preoperative spherical equivalent was -3.2 Diopters (D) (SD 4.14), and mean cylinder -2.94 D (SD 1.24). Postoperatively the best unaided vision was obtained using the ASLA modality 0.3 LogMAR (SD 0.4), whereas the best corrected vision was obtained using the cTEN approach 0.1 (SD 0.1).

Conclusions

Customized transepithelial PRK approaches optimize best corrected vision and visual quality (by reducing HOAs).  Transepithelial PRK with simultaneous crosslinking may offer an alternative to keratoplasty in contact lens intolerant keratoconus.