April 2009
Volume 50, Issue 13
ARVO Annual Meeting Abstract  |   April 2009
Simultaneous Topo-Guided PRK and Riboflavin/UVA Crosslinking for the Correction of Progressive Keratoconus
Author Affiliations & Notes
  • R. R. Krueger
    Refractive Surg-Cole Eye Inst, Cole Eye Institute, Cleveland, Ohio
  • A. J. Kanellopoulos
    Refractive Surgery, Athens, Athens, Greece
  • Footnotes
    Commercial Relationships  R.R. Krueger, ., F; A.J. Kanellopoulos, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 5483. doi:
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      R. R. Krueger, A. J. Kanellopoulos; Simultaneous Topo-Guided PRK and Riboflavin/UVA Crosslinking for the Correction of Progressive Keratoconus. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5483.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To introduce a simultaneously delivered therapy that both corrects aberrations and stiffens the corneal collagen of eyes with progressive keratoconus.

Methods: : Two patients with progressive keratoconus underwent partial treatment with topographic customized photorefractive keratectomy (PRK) in the worse eye, and then were immediately cross-linked with riboflavin 0.1% drops every 5 minutes while exposed to 365 nm ultraviolet (UVA) light at 3.0 mW/cm2 for 30 minutes. Pre and postoperative testing included manifest and cycloplegic refraction, corneal topography, pachymetry and slit lamp examination of corneal clarity with followup at 3, 6 and 12 months.

Results: : Both treated eyes experienced rapid healing of the epithelial surface within 5 days and progressive improvement of vision. In the first case, partial treatment primarily reduced the astigmatism and aberrations, leading to a residual myopic refraction which allowed for successful wear of a soft contact lens. In the second case, laser treatment led to a near emmetropic refraction with an uncorrected visual acuity of 20/20 at 3 months and beyond. In both cases, the outcome remained stable with no shift in refraction or topography over the first postop year.

Conclusions: : Topo-guided PRK followed by riboflavin/UVA cross-linking is a safe and effective therapy that both halts the progression of keratoectasia and significantly reduces the spherocylindrical refraction and aberrations to improve the visual function of patients with progressive keratoconus.

Keywords: keratoconus • refractive surgery • cornea: stroma and keratocytes 

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