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Hyperopic LASIK combined with higher-fluence topography-customized application of CXL irradiation: a novel technique

Poster Details

First Author: V.Moustou GREECE

Co Author(s):    A. Kanellopoulos   G. Asimellis           

Abstract Details


To report a novel application of topographically-customized collagen crosslinking aiming to achieve refractive and keratometric stability following hyperopic LASIK.

Setting: Clinical and Research Eye Institute, Athens Greece


Topography-guided treatment employed (a) surgery planning by Placido-topography (Vario, Alcon, Ft. Worth, TX) (b) femto-second-laser assisted corneal flap 140-μm deep, 9.5-mm diameter (FS200, Alcon) (c) excimer-laser ablation centered on the 1st Purkinje-reflection (EX500, Alcon). Following ablation, with the flap folded onto itself, protected with a dry Wexel sponge, 0.10% saline-diluted riboflavin was placed on the stromal bed for 60-seconds. Then a peripheral annular-shaped topographically-customizable design was employed for high-fluence UV-A irradiation (KXL II, Avedro, Waltham, MA). Visual acuity, cornea clarity, keratometry, topography, and pachymetry, including corneal epithelial pachymetry, as well as endothelial cell counts were evaluated.


42 eyes were available for follow-up up to 2-years. Uncorrected distance visual acuity improved from 5.5/10 to 9.2/10. At 24 (8–37) months, 75.5% of the eyes were in the ±0.50 D range and 94.4% were in the ±1.00 D range of the refractive goal. Postoperatively, the mean sphere value was −0.39 ± 0.3 and the cylinder value was −0.35 ± 0.25. Topographic evidence showed that ablation was made in the visual axis and not in the center of the cornea, thus correlating with the angle kappa. No significant complications were encountered.


We introduce herein the novel application of a topographically-customizable collagen crosslinking application to achieve refractive and keratometric stability following hyperopic LASIK. FINANCIAL DISCLOUSRE: One or more of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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