Topography-guided transepithelial PRK after intracorneal ring segments implantation and corneal collagen CXL in a three-step procedure for keratoconus.
Details
Serval ID
serval:BIB_94D3115202A7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Topography-guided transepithelial PRK after intracorneal ring segments implantation and corneal collagen CXL in a three-step procedure for keratoconus.
Journal
Journal of refractive surgery
ISSN
1081-597X (Print)
ISSN-L
1081-597X
Publication state
Published
Issued date
01/2013
Peer-reviewed
Oui
Volume
29
Number
1
Pages
54-58
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
To present the results of topography-guided transepithelial photorefractive keratectomy (PRK) after intracorneal ring segments implantation followed by corneal collagen cross-linking (CXL) for keratoconus.
In this prospective case series, 10 patients (16 eyes) with progressive keratoconus were included. All patients underwent topography-guided transepithelial PRK after Keraring intracorneal ring segments (Mediphacos Ltda) implantation, followed by CXL treatment. The follow-up period was 6 months after the last procedure for all patients. Time interval between both intracorneal ring segments implantation and CXL and between CXL and topography-guided transepithelial PRK was 6 months.
LogMAR mean uncorrected distance visual acuity and mean corrected distance visual acuity were significantly improved (P<.05) from 1.14±0.36 and 0.75±0.24 preoperatively to 0.25±0.13 and 0.13±0.06 after the completion of the three-step procedure, respectively. Mean spherical equivalent refraction was significantly reduced (P<.05) from -5.66±5.63 diopters (D) preoperatively to -0.98±2.21 D after the three-step procedure. Mean steep and flat keratometry values were significantly reduced (P<.05) from 54.65±5.80 D and 47.80±3.97 D preoperatively to 45.99±3.12 D and 44.69±3.19 D after the three-step procedure, respectively.
Combined topography-guided transepithelial PRK with intracorneal ring segments implantation and CXL in a three-step procedure seems to be an effective, promising treatment sequence offering patients a functional visual acuity and ceasing progression of the ectatic disorder. A longer follow-up and larger case series are necessary to thoroughly evaluate safety, stability, and efficacy of this innovative procedure.
In this prospective case series, 10 patients (16 eyes) with progressive keratoconus were included. All patients underwent topography-guided transepithelial PRK after Keraring intracorneal ring segments (Mediphacos Ltda) implantation, followed by CXL treatment. The follow-up period was 6 months after the last procedure for all patients. Time interval between both intracorneal ring segments implantation and CXL and between CXL and topography-guided transepithelial PRK was 6 months.
LogMAR mean uncorrected distance visual acuity and mean corrected distance visual acuity were significantly improved (P<.05) from 1.14±0.36 and 0.75±0.24 preoperatively to 0.25±0.13 and 0.13±0.06 after the completion of the three-step procedure, respectively. Mean spherical equivalent refraction was significantly reduced (P<.05) from -5.66±5.63 diopters (D) preoperatively to -0.98±2.21 D after the three-step procedure. Mean steep and flat keratometry values were significantly reduced (P<.05) from 54.65±5.80 D and 47.80±3.97 D preoperatively to 45.99±3.12 D and 44.69±3.19 D after the three-step procedure, respectively.
Combined topography-guided transepithelial PRK with intracorneal ring segments implantation and CXL in a three-step procedure seems to be an effective, promising treatment sequence offering patients a functional visual acuity and ceasing progression of the ectatic disorder. A longer follow-up and larger case series are necessary to thoroughly evaluate safety, stability, and efficacy of this innovative procedure.
Keywords
Adolescent, Adult, Collagen/metabolism, Combined Modality Therapy, Corneal Stroma/metabolism, Corneal Topography, Cross-Linking Reagents/therapeutic use, Humans, Keratoconus/drug therapy, Keratoconus/metabolism, Keratoconus/surgery, Keratoconus/therapy, Photorefractive Keratectomy, Photosensitizing Agents/therapeutic use, Prospective Studies, Prostheses and Implants, Prosthesis Implantation, Treatment Outcome, Visual Acuity/physiology, Young Adult
Pubmed
Web of science
Create date
01/10/2019 14:06
Last modification date
06/10/2019 6:26