Long-term Results of Mini Asymmetric Radial Keratotomy for the Treatment of Keratoconus

Abstract

Aim: To present long-term results of mini asymmetric radial keratotomy (MARK) for the treatment of mild to moderate keratoconus, with an average follow-up of 7.3 years and a minimum of 6 years. Design: Retrospective clinical study. Materials and methods: The postoperative outcomes of 66 eyes (45 patients) were selected and retrospectively analyzed. Inclusion criteria were progressive stages I and II keratoconus (Kc) and contact lens intolerance, while exclusion criteria were advanced stages of the pathology and chronic or recurrent ocular infections. Tomography-and topography-guided miniincisions were customised and performed sectorally with a calibrated diamond knife and custom-made corneal markers. Results: After a minimum follow-up of 6 years, mean keratometry improved in 91% of cases (from 47.25 D to 44.61 D), and mean pachymetry improved in 98% of cases (from 446 μm to 484 μm), while best spectacle-corrected visual acuity improved for 95% of patients, from 0.23 LogMAR (5.9/10) to 0.095 LogMAR (7.7/10). Conclusion: MARK improved both mean keratometry and mean pachymetry, thus halting the progression of keratoconus, while improving visual acuity. The long-term results suggest that MARK should be considered as one of the conservative treatments for moderate to mild progressive keratoconus.

Mini Asymmetric Radial Keratotomy and Corneal Cross-linking for the Treatment of a Bilateral Stage IV Keratoconus in a 14-year-old Child

“…Clearly identified in 1854 by John Nottingham, this degenerative disease requires an invasive intervention such as corneal transplantation in 15-20% of cases, although a number of conservative procedures has been developed. These are Corneal Collagen Cross-linking (CXL) (2), Intrastromal Corneal Ring Segments (ICRS) (3), Mini Asymmetric Radial Keratotomy (MARK) (4), Circular Keratotomy (CK and FemtoCK) (5) and Conductive Keratoplasty (CKP).…”