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Michele Angely Pacheco, Arturo J Ramirez-Miranda, Juan Carlos Serna-Ojeda, Alejandro Navas, Aida Jimenez-Corona, Omar Santana-Cruz, Enrique O Graue-Hernandez; Corneal collagen crosslinking in post- LASIK ectasia. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5269.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report visual, refractive and topographic outcomes in post-LASIK ectasia subjects that underwent corneal collagen crosslinking (CXL).
Methods: Single center consecutive case series. Patients older than 18 years old with post-LASIK ectasia diagnosis and progression evidence (increase Kmax >1D), who underwent CXL were included. Avedro protocol was used as epithelium on modality in pachymetry >370um - <400um, and epithelium off in pachymetry >400um. Pre and postoperative uncorrected (UCVA) and best corrected visual acuity (BCVA), Kmin, Kmax, spherical equivalent and pachymetry were measured. Paired T – test using Stata 13.1 was used for the analysis.
Results: Twenty eyes of 12 patients were enrolled, mean age was 37 years old (range 22 to 58 years) with a mean follow-up of 6 months (range 4 to 14 months). Increase in spherical equivalent was found, however there was no statistically significant difference between preoperative (-3.46D ±5.41) and postoperative (-3.53D±5.05) value (p=0.93). Also non-significant change was noted in UCVA, an improvement from 0.93 logMar (20/167 Snellen) preoperative to 0.827 logMar (20/134 Snellen) postoperative (P=0.39), and in BCVA 0.319 logMar (20/41 Snellen) preoperative to 0.264 logMar (20/36 Snellen) postoperative (P=0.32). An increase of 0.58D (± 1.78SD, P=0.16) in Kmin value, 0.79D (± 1.16SD, P=0.0065) in Kmax value, and a decrease in 22.6um (± 56.43SD, P=0.08) in pachymetry values were found. Eight patients (40%) presented progression during the follow-up.
Conclusion. An increase in postoperative keratometric values at 6 months was found, however no statistically significant, and expecting a posterior decrease in longer follow-up. There was an improvement in UCVA and BCVA, probably due to stabilization in corneal biomechanical properties posterior to CXL, and a reduction in pachymetry values is possibly secondary to stromal compaction posterior to CXL. With a high rate of progression after treatment, post-LASIK ectasia remains a challenging disease.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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