American journal of ophthalmology · 2011
Simultaneous topography-guided photorefractive keratectomy followed by corneal collagen cross-linking for keratoconus.
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Kymionis George D, Portaliou Dimitra M, Kounis George A, Limnopoulou Aliki N, Kontadakis Georgios A, Grentzelos Michael A
Аннотация
PURPOSE: To present the long-term results after simultaneous photorefractive keratectomy followed by corneal collagen cross-linking for keratoconus.
DESIGN: Prospective, interventional, consecutive case series.
METHODS: In this study, 26 patients (31 eyes) with progressive keratoconus were included. All patients underwent customized topography-guided photorefractive keratectomy immediately followed by corneal collagen cross-linking with the use of riboflavin and ultraviolet A irradiation. Epithelium was removed by transepithelial phototherapeutic keratectomy in all cases.
RESULTS: Mean follow-up was 19.53 ± 3.97 months (range, 12 to 25 months). Mean preoperative spherical equivalent was -2.3 ± 2.8 diopters (D), whereas at the last follow-up examination, it was significantly (P < .001) reduced to -1.08 ± 2.41 D. Logarithm of the minimal angle of resolution uncorrected and best-corrected visual acuity were reduced significantly by 0.46 and 0.084 (P < .001), respectively, at the last follow-up examination. Finally, mean steep and flat keratometry readings were reduced by 2.35 (P < .001) and 1.18 (P = .013) at the last follow-up examination.
CONCLUSIONS: Simultaneous photorefractive keratectomy followed by corneal collagen cross-linking seems to be a promising treatment alternative in our series of keratoconic patients.
DESIGN: Prospective, interventional, consecutive case series.
METHODS: In this study, 26 patients (31 eyes) with progressive keratoconus were included. All patients underwent customized topography-guided photorefractive keratectomy immediately followed by corneal collagen cross-linking with the use of riboflavin and ultraviolet A irradiation. Epithelium was removed by transepithelial phototherapeutic keratectomy in all cases.
RESULTS: Mean follow-up was 19.53 ± 3.97 months (range, 12 to 25 months). Mean preoperative spherical equivalent was -2.3 ± 2.8 diopters (D), whereas at the last follow-up examination, it was significantly (P < .001) reduced to -1.08 ± 2.41 D. Logarithm of the minimal angle of resolution uncorrected and best-corrected visual acuity were reduced significantly by 0.46 and 0.084 (P < .001), respectively, at the last follow-up examination. Finally, mean steep and flat keratometry readings were reduced by 2.35 (P < .001) and 1.18 (P = .013) at the last follow-up examination.
CONCLUSIONS: Simultaneous photorefractive keratectomy followed by corneal collagen cross-linking seems to be a promising treatment alternative in our series of keratoconic patients.
Предметные рубрики MeSH
AdultCollagenCombined Modality TherapyCorneal StromaCorneal TopographyCross-Linking ReagentsFemaleFollow-Up StudiesHumansKeratoconusLasers, ExcimerMaleMiddle AgedPhotochemotherapyPhotorefractive KeratectomyPhotosensitizing AgentsProspective StudiesRefraction, OcularRiboflavinTreatment OutcomeUltraviolet RaysVisual AcuityYoung Adult