Long-Term Outcomes Of Accelerated Transepithelial Corneal Crosslinking For Post-Lasik Ectasia: An Average Of 115-Month Follow-Up

To evaluate the long-term safety and efficacy of accelerated transepithelial corneal crosslinking (ATE-CXL) for post-laser-assisted in situ keratomileusis (LASIK) ectasia.

Eye and ENT hospital of Fudan University, Department of Ophthalmology, Shanghai, China.

Twenty-four eyes of 24 patients with progressive post-LASIK ectasia (17 men and 7 women) with a mean age of 28.25 ± 5.29 years undergoing ATE-CXL were enrolled in the study. Clinical examinations were conducted preoperatively and postoperatively such as corrected distance visual acuity (CDVA), manifest refraction and endothelial cell density (ECD). Epithelial thicknesses were measured using optical coherence tomography (OCT), and corneal keratometry, corneal thickness and posterior elevation were measured using Pentacam. Patients were followed up at 1, 6, 12, 48 months and last visit (range from 101-131 months) postoperatively.

There were no complications in any of the cases during or after ATE-CXL. No significant changes were observed in CDVA or ECD for up to 115-months (p > 0.05). The spherical equivalent significantly decreased from -7.43 ± 5.89 D postoperatively to -8.40 ± 5.78 D at 115-month postoperatively (p < 0.05). Maximum keratometry (Kmax) decreased from 54.45 ± 7.82 D to 53.29 ± 7.06 D, and corneal central thickness increased from 416.08 ± 43.24 μm to 432.00 ± 48.02 μm at the last visit. No statistically significant differences were observed in Kmax or corneal thickness during the 115-month follow-up (p > 0.05). The values of posterior highest elevation were stable at 48-months after ATE-CXL (p > 0.05), but increased at 115-months follow-up (p < 0.05).

ATE-CXL is a safe and effective treatment in progressive post-LASIK ectasia patients. The keratometry and corneal thickness remained stable during the 115-month follow-up.