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A.U. Koeller, M. Kohlhaas, E. Spoerl, L. Pillunat; Treatment of Keratectasia After LASIK With Riboflavin/UV Light Cross–Linking . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1317.
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© ARVO (1962-2015); The Authors (2016-present)
Keratectasia after LASIK is a rare but severe complication. Penetrating keratoplasty is the common way of treatment to stabilize or improve visual function. We report about a new technique of molecular cross linking of corneal stroma to avoid progression of the disease.
We treated 16 eyes of 16 patients with keratectasia after myopic LASIK. The presurgical refraction was –3 – –6.5 D and the corneal thickness before LASIK was > 530 µm in 15 of the patients, just one had a corneal thickness of < 500 µm. All patients were treated with riboflavin/UV light (370 nm, 30 min) cross linking. Visual acuity, corneal pachymetry and corneal curvature were measured before and after the treatment. The follow up time was 3 – 36 months.
In the first weeks after cross linking visual function was reduced (–0.5 snellen lines +/– 1 snellen line) but after 3 months the patients showed an improvement of vision by 1.4 +/– 1 snellen lines. The corneal thickness showed no significant change after treatment (mean value 525 µm). During the follow up time of one year the astigmatism values remained stable (mean: 4.5 +/– 2D). In all of the patients a progression of keratectasia could be avoided by the cross linking technique.
To avoid keratectasia after LASIK the guidelines of the committee for refractive surgery must be respected. After LASIK a long term follow up is necessary because keratectasia can develop slowly but also very rapidly. Riboflavin/UV light cross linking is a new technique which stops progression of keratectasia by stiffening the anterior part of the corneal stroma.
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