Femto Lasik Combined With Prophylactic Corneal Cross-Linking For Correction Of Myopia And Astigmatism.1-Year Results.

To evaluate the 1-year outcomes of Femto LASIK combined with prophylactic corneal collagen cross-linking (CXL) in correcting myopia and astigmatism in cases with increased estimated risk of postoperative corneal ectasia (thin corneas, high myopia, abnormal corneal topography).

Dr.Solomatin Eye Center

The retrospective study included 100 eyes of 50 patients. Group 1 (50 eyes of 25 patients) with increased risk of postoperative corneal ectasia, underwent femtosecond laser-assisted LASIK (FS-LASIK) combined with prophylactic CXL(30 mW/cm², 90 seconds with continuous ultraviolet-A). Group 2 (50 eyes of 25 patients) with normal corneal topography, who underwent FS-LASIK alone, were used as controls. Refractive and visual outcomes and Scheimpflug topo/tomography and OCT were analyzed preoperatively and 1 day,1, 3 and 12 months postoperatively. Possible side effects and complications were also studied.

There was no significant difference in outcomes between both groups(P > .05)  during the 12 months follow-up except the 1-st day. The uncorrected distance visual acuity and postoperative pain were significantly worse on day 1 in eyes receiving CXL. Severe photophobia was observed in 3(12%) people after LASIK Xtra and in no one in control group. At 12 months, 48 (96%) and 47 ( 94%) of the eyes achieved uncorrected distance visual acuity of 20/25 or better in LASIK with CXL and LASIK only, respectively. 6 eyes (12%) from CXL group got intrastromal haze grade 1 and 2. Topography showed stability of corneal curvature with no signs of keratectasia in both groups at 12 months.

LASIK Xtra showed promising results in terms of stability, efficacy and predictability. But FS-Lasik with CXL is inferior to standard FS-LASIK in terms of safety: a higher risk of haze formation, transient photophobia and postoperative pain syndrome.