Safety and Efficacy of Prophylactic Ultraviolet-A-Induced Crosslinking After High-Risk Myopic Photorefractive Keratectomy

Abstract

Purpose: : To evaluate the safety and efficacy of adjunctive treatment with ultraviolet-A (UVA)-induced crosslinking (CCL) on high-risk myopic patients after photorefractive keratectomy (PRK).

Methods: : 45 high-risk myopic patients underwent PRK using Wavelight excimer laser platform. Pre-operative evaluation included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refractive error, keratometry (K), corneal topography (T), pachymetry (P), and endothelial cell count (ECC). Following PRK, the eyes underwent UVA-induced CCL (370 nm, 7 mW/cm² for 10 minutes) after the administration of 0.1% riboflavin drops. The mean follow-up was 1.6 years (range 1-4 years).

Results: : mean UCVA improved from 20/100 (Snellen chart) to 20/15, BSCVA from 20/20 to 20/15, and the spherical equivalent from -6.25D to +0.2D. Mean K changed from 45.5D to 39D, P from 495 to 385, and ECC from 2750 to 2800. None of the cases developed signs of ectasia.

Conclusions: : UVA CCL appears to be safe and effective adjunctive treatment to prevent ectasia in high-risk myopic patients undergoing PRK.

Keywords: cornea: stroma and keratocytes