Evaluation of a Novel Technique in the Management of Post-Lasik Ectasia: Under-The-Flap, Partial, Topography-Guided Therapeutic Ablation (tLASIK) Combined With Simultaneous Collagen Cross-Linking (CXL)

Abstract

Purpose: : Evaluation of the safety and efficacy of topography-guided LASIK (tLASIK) and simultaneous collagen cross-linking (CXL).

Methods: : 7 eyes of 4 patients with post-LASIK ectasia were evaluated before and after treatments of tLASIK and CXL for their UCVA, BSCVA, refraction, keratometry(K), topography, minimal pachymetry, endothelium cell count (ECC), cornea haze and ectasia stability. All eyes had a partial topography guided ablation within the original flap, followed by instillation of 0.1% riboflavin solution within the flap and then CXL with 7mW/cm² UVA irradiation for 10 minutes. Mean follow-up was 15.5 months(12 to 38).

Results: : Visual function recovery took an average of 2 days post-operatively. UCVA: from 0.21 to 0.42, BSCVA: from 0.41 to 0.57. SER: 2.1 diopters, Mean haze score: 0.4, Mean keratometry reduction: 2.4 diopters. Two eyes appeared to regress within one year.

Conclusions: : Simultaneous tLASIK and CXL carries an unique advantage of rapid rehabilitation and minimal patient discomfort post-operatively. It appears to be safe and moderately effective in stabilizing ectasia progression and enhancing visual rehabilitation in post-LASIK ecstasia.

Keywords: refractive surgery: LASIK • refractive surgery: corneal topography • refractive surgery: other technologies