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M. Ewald, J. Kanellopoulos; Limited Topography-Guided Surface Ablation (TGSA) Followed by Stabilization With Collagen Cross-Linking With Uv Irradiation & Riboflavin (UVACCL) for Keratoconus (KC). Invest. Ophthalmol. Vis. Sci. 2008;49(13):4338.
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To investigate the safety & efficacy of TGSA and UVACCL as one procedure for keratoconus (KC) visual rehabilitation.
We evaluated limited topography-guided surface ablation (TGSA) with the Wavelight device, followed by UV-irradiation and riboflavin collagen crosslinking (UVACCL) in 45 eyes with KC. Refraction, uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), pentacam topography (PT), endothelial cell count (ECC) and pachymetry (PC) were evaluated pre-treatment and post-treatment, for an average of 19 months (ranging from 14-21).
Keratoconus progression stabilized after TGSA and UVACCL treatment, with the following results: Average UCVA improved from 20/400 to 20/100.Average BSCVA improved from 20/100 to 20/30.On average, there was a reduction in the refractive correction sphericalequivalent of 6.4 D per eye.ECC demonstrated no statistical change.The PT mean keratometry reduced from 53 to 44.PC was reduced from 420 to 380 microns.1 eye needed to undergo penetrating keratoplasty (PK)despite TGSA and UVACCL treatment.
TGSA & UVACCL may offer effective visual rehabilitation for KC, and it may delay or eliminate the need for PK. Long-term results with greater follow-up are necessary to confirm the stability and safety of UVACCL in controlling and stabilizing KC.
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