Non-topography–guided PRK Combined With CXL for the Correction of Refractive Errors in Patients With Early Stage Keratoconus

Fadlallah, Ali; Dirani, Ali; Chelala, Elias; Antonios, Rafic; Cherfan, George; Jarade, Elias

doi:10.3928/1081597x-20140903-02

Cited by 31 publications

(14 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…All evaluated visual and refractive parameters demonstrated highly significant improvement after the surgery in both studied groups (all P < 0.001) at 6 months after surgery with no significant changes till the end of follow-up indicating plateauing and stabilization of outcome (Table 3). On the other hand, in one study carried in early cases of keratoconus using non-topo guided PRK with CXL, the authors demonstrated significant improvement in the UDVA, spherical equivalent, and cylinder while the CDVA remained stable [20]. The significant visual improvement obtained in our study in both UDVA and CDVA was due to the reduction of the spherocylindrical error and the minimization of HOAs.…”

Section: Discussionsupporting

confidence: 56%

Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation

Samra

Emam

Farag

et al. 2016

Journal of Ophthalmology

View full text Add to dashboard Cite

Aim. To compare objective and subjective outcome after simultaneous wave front guided (WFG) PRK and accelerated corneal cross-linking (CXL) in patients with progressive keratoconus versus sequential WFG PRK 6 months after CXL. Methods. 62 eyes with progressive keratoconus were divided into two groups; the first including 30 eyes underwent simultaneous WFG PRK with accelerated CXL. The second including 32 eyes underwent subsequent WFG PRK performed 6 months later after accelerated CXL. Visual, refractive, topographic, and aberrometric data were determined preoperatively and during 1-year follow-up period and the results compared in between the 2 studied groups. Results. All evaluated visual, refractive, and aberrometric parameters demonstrated highly significant improvement in both studied groups (all P < 0.001). A significant improvement was observed in keratometric and Q values. The improvement in all parameters was stable till the end of follow-up. Likewise, no significant difference was determined in between the 2 groups in any of recorded parameters. Subjective data revealed similarly significant improvement in both groups. Conclusions. WFG PRK and accelerated CXL is an effective and safe option to improve the vision in mild to moderate keratoconus. In one-year follow-up, there is no statistically significant difference between the simultaneous and sequential procedure.

show abstract

Section: Discussionsupporting

confidence: 56%

Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation

Samra

Emam

Farag

et al. 2016

Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Several clinical reports demonstrated stability in corneas that had undergone a combination of CXL and PRK, either sequentially or combined. Patients experienced improvement in spherical equivalent (SE), defocus equivalent, uncorrected and best corrected visual acuity, high order aberrations and Kmax with stabilization of keratoconus progression during a follow up period of 12–24 months [ 121 – 124 ].…”

Section: Reviewmentioning

confidence: 99%

Collagen cross-linking: when and how? A review of the state of the art of the technique and new perspectives

Mastropasqua¹

2015

Eye and Vis

View full text Add to dashboard Cite

Since the late 1990s corneal crosslinking (CXL) has been proposed as a new possibility to stop progression of keratoconus or secondary corneal ectasia, with the promising aim to prevent progressive visual loss due to the evolution of the pathology and to delay or avoid invasive surgical procedures such as corneal transplantation. The possibility of strengthening corneal tissue by means of a photochemical reaction of corneal collagen by the combined action of Riboflavin and ultraviolet A irradiation (UVA), radically modified the conservative management of progressive corneal ectasia. This is a review of the state of the art of CXL, reporting basic and clinical evidence. The paper describes basic principles, advantages and limits of different CXL techniques and possible future evolution of the procedure.

show abstract

“…It is important to note that meaningful comparisons of the current study outcomes to published literature related to TG laser treatment are difficult given the significant differences in the magnitude of corneal ectasia (from early to advanced keratoconus) across studies 6,9,13,15. In addition, the TG ablations are centered on the corneal vertex and encompass the whole cornea, whereas WG ablations are centered on the pupil; therefore, it may be futile to compare the current study results with literature.…”

Section: Discussionmentioning

confidence: 99%

High-resolution wavefront-guided surface ablation with corneal cross-linking in ectatic corneas: a pilot study

Tamayo¹,

Castell²,

Vargas³

et al. 2017

OPTH

View full text Add to dashboard Cite

PurposeA preliminary study to evaluate the outcomes of high-resolution wavefront-guided (HRWG) photorefractive keratectomy (PRK) with simultaneous corneal cross-linking (CXL) in ectasia eyes.MethodsSixteen eyes of 11 patients (mean age 31.9±9.8 years; range: 15–48 years) with keratoconus or post-laser-assisted in situ keratomileusis ectasia underwent HRWG PRK with simultaneous CXL. Manifest refraction, uncorrected (UDVA) and corrected distance visual acuity (CDVA), and keratometric and aberrometric outcomes are reported at 12 months.ResultsSignificant improvement was observed postoperatively in visual acuity, refraction, and keratectomy in all eyes. At postoperative 12 months, 87.5% eyes were within ±1.0 D of attempted correction and 81.25% of eyes had a postoperative UDVA of 20/32 or better. A gain of 2 or more lines of CDVA was observed in 12.5% (2/16) of eyes and there was no change in CDVA lines in 25% (4/16) eyes. A substantial reduction in higher-order aberrations was observed in all eyes postoperatively; however, the improvement was not statistically significant.ConclusionThe outcomes of HRWG PRK in ectasia eyes with estimated residual stromal bed thickness of at least 350 μm (without epithelium) are promising at postoperative 1 year and provide surgeons with a valuable tool to improve vision with a high degree of refractive predictability.

show abstract

Non-topography–guided PRK Combined With CXL for the Correction of Refractive Errors in Patients With Early Stage Keratoconus

Abstract: Combined non-topography-guided PRK and CXL is an effective and safe option for correcting mild refractive error and improving visual acuity in patients with early stable keratoconus.

Cited by 31 publications

References 26 publications

Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation

Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation

Collagen cross-linking: when and how? A review of the state of the art of the technique and new perspectives

High-resolution wavefront-guided surface ablation with corneal cross-linking in ectatic corneas: a pilot study

Contact Info

Product

Resources

About