Simultaneous Topography-Guided Photorefractive Keratectomy Followed by Corneal Collagen Cross-linking for Keratoconus

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• 作者：George D.  ; Kymionis  ; ;   ; ^{kymionis@med.uoc.gr} ; Dimitra M.  ; Portaliou ; George A.  ; Kounis ; Aliki N.  ; Limnopoulou ; Georgios A.  ; Kontadakis ; Michael A.  ; Grentzelos
• 刊名：American Journal of Ophthalmology
• 出版年：2011
• 出版时间：November 2011
• 年：2011
• 卷：152
• 期：5
• 页码：748-755
• 全文大小：2390 K

文摘

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 ¡À 3.97 months (range, 12 to 25 months). Mean preoperative spherical equivalent was ?.3 ¡À 2.8 diopters (D), whereas at the last follow-up examination, it was significantly (P < .001) reduced to ?.08 ¡À 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.