Crosslinking-LASIK combination treatment shows promise

Combining cross-linking within a LASIK procedure using Lasik Xtra (Avedro) seems to provide a simple, fast and effective means of improving the biomechanical safety of the cornea for patients with moderate to high ametropias, according to a French researcher.

“LASIK Xtra combines the proven efficacy of conventional collagen crosslinking (CXL) for the treatment of keratoconus together with the corneal stability that we seek to obtain with laser treatment of moderate to strong ametropias. It also reduces the risk of corneal complications such as post-LASIK ectasia,” said Charles Ghenassia MD

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Dr Ghenassia’s study included a total of 15 patients: the first 10 patients were treated between March and October 2013 with UVA treatment of 18 mW/cm2 and riboflavin for 90 seconds and 120 seconds. The next five patients underwent the accelerated Avedro procedure using the KXL lamp for 60 seconds combined with VibeX riboflavin and 90 seconds of UVA exposure at 30 mW/cm2.

Eight of the patients were myopic with a preoperative mean of -6.50 D and the remaining seven patients were hyperopes with a mean spherical equivalent of +3.25 D preoperatively.

The results with three months follow-up showed no significant difference in terms of corneal clarity and flap healing in the immediate postoperative period compared to conventional LASIK. Patients seemed to show good tolerance for the procedure and no regression was observed during the follow-up.

“We obviously need longer follow-up to verify any regression and corneal stability over the longer term,” said Dr Ghenassia, “but it is certainly a promising approach which adds just a few minutes to the standard LASIK procedure time. However, the extra cost of the procedure needs to be considered given the difficult economic climate for refractive surgery at the moment,” he said.

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