5 Years Follow Up Of Early Keratoconic Eyes Treated By Aspheric Versus Corneal Wavefront Guided All Surface Ablation (Asla/Transprk) And Corneal Cross-Linking (Cxl). A Study Using Amsler-Krumeich And Abcd Keratoconus Classification

To analyse and compare early keratoconic eyes according to two different classifications (Amsler-Krumeich and ABCD) which underwent 2 different customization treatment levels i.e. aspheric vs. corneal wavefront guided ASLA/TransPRK combined with cross-linking. Subsequently, the final refractive status will be reclassified 5 years later, according to the same aforementioned keratoconus classification systems.

Emmetropia Eye Institute, Heraklion, Crete, Greece 

Patients with topographically significant keratoconus (Grade II & III in the Amsler-Krumeich classification and Stage I & II in the ABCD classification) with limited corrected vision and intolerant of contact lenses underwent single step ASLA (aspheric vs. corneal wavefront guided) and sequential corneal cross-linking. Preoperative vision, refraction, corneal topography and wavefront were assessed, with postoperative assessment at 1 year, 3 years and 5 years.

35 eyes from 52 patients were included in the retrospective chart review. Mean age was 24 years (SD 6, range 18 to 30). Mean preoperative best corrected vision was 0.5 LogMAR (SD 0.2). Mean preoperative spherical equivalent was -4.5 Diopters (D) (SD 3.98), and mean cylinder -2.50 D (SD 1.18). Postoperatively both the best unaided and corrected vision were obtained using corneal wavefront ASLA.

The postoperative reclassification of the cases will be presented and compared. Customized transepithelial PRK approaches optimize best corrected vision and visual quality. Corneal wavefront ASLA with simultaneous cross-linking, provided that the initial pachymetry permits, may offer a plausible alternative in visual rehabilitation of keratoconus.