June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
3 year outcomes of corneal wavefront guided PRK and simultaneous accelerated crosslinking in keratoconus
Author Affiliations & Notes
  • Enrique O Graue-Hernandez
    Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Eduardo Gonzalez Lubcke
    Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Jesus Cabral-Macías
    Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Denisse Pinkus
    Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Arturo Ramirez Miranda
    Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Alejandro Lichtinger-Dondish
    Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Alejandro Navas
    Cornea, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Footnotes
    Commercial Relationships   Enrique Graue-Hernandez, None; Eduardo Gonzalez Lubcke, None; Jesus Cabral-Macías, None; Denisse Pinkus, None; Arturo Ramirez Miranda, None; Alejandro Lichtinger-Dondish, None; Alejandro Navas, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 983. doi:
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      Enrique O Graue-Hernandez, Eduardo Gonzalez Lubcke, Jesus Cabral-Macías, Denisse Pinkus, Arturo Ramirez Miranda, Alejandro Lichtinger-Dondish, Alejandro Navas; 3 year outcomes of corneal wavefront guided PRK and simultaneous accelerated crosslinking in keratoconus. Invest. Ophthalmol. Vis. Sci. 2021;62(8):983.

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

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Abstract

Purpose : To report long term outcomes of corneal wavefront guided PRK followed by same day accelerated crosslinking in keratoconus patients.

Methods : Retrospective review of clinical records. Grade I and II keratoconus (Amsler-Krumeich classification) with evidence of clinical progression were
included. In all cases, corneal wavefront guided PRK (Sirius corneal tomographer and Amaris 750 Hz Schwind ) combined with accelerated. corneal crosslinking 0.1% riboflavin (Vibex RapidTM) for 10 minutes.UVA pulsed radiation (365 nm) for 8 minutes at 30mW/cm2 with an interval of one second (Avedro). Measuered variables included UCVA, CDVA, Sphere, Cylinder, pachymetry, and spherical aberration, coma, trefoil and MTF and RMS. Follow-up was performed at 1 day, 1 week, month 1, 3, 6, 12, 48 and 72. Results are presented using waring standard graphs and statistical analysis with STATA v.12.

Results : 30 eyes of 16 patients were treated. Mean age was 29.53. Mean follow-up 32 ± 9.7 months (range 9-44) Mean central ablation was 37.63 microns. Preoperative values and postoperative values at the last follow-up were: LogMAR UDVA 0.86 ± .34 vs 0.18± 19 ; LogMAR CDVA 0.5 ± 0.8 vs 0.04 ± 0.08; sphere (D) 1.09 ± 1.45 vs 0.25 ± 0.8 ; Cylinder -2.76± 1.45 vs 1.5 ± 1.1; MRSE -2.46± 1.17 vs 1.19 ± 1.4; corneal thinnest point(μ) 501.7 ± 25.95 vs 459 ± 31.4 ; K1 42.9 ± 1.15 vs 41.74 ± 1.30 ; K2.45.95 ± 1.19 vs 43.9 ± 2.2; WFE RMS (μ) 2.01 ± 0.1 vs 1.44 ± 0.8 ;HOA(μ) 0.64 ± 0.4 vs 0.54 ± 0.2; Spherical Aberration(μ) 0.09 ± 0. 0.6 vs 0.9 ± 0.1 ; Trefoil 0.4 ± 0.3 vs 0.33 ± 0.2 and Coma (μ) 0.33±0.26 vs 0.27 ± 0.18. All comparisons of pre and post op values were statistically signficant with p < 0.05 with the exception of CDVA p 0.68, Spherical aberration 0.9, and Coma 0.31. Only 1 eye (3.3%) lost 2 lines of CDVA and16 eyes ( 53%) gained at leat 1 line of CVDVA. Refraction remained stable over the followup period. Complications: 6 eyes had irregular conreal surface that resolved in the first month and mild corneal haze (Grade I) was observed in all eyes and resolved spontaneously by 3 months.

Conclusions : Combination of photorefractive keratectomy and corneal cross linking is a
safe and effective treatment that produces corneal and refractive changes that remain
stable 3 years after the procedure. No signs of progression were observed in patients
keratoconus grade I and II.,

This is a 2021 ARVO Annual Meeting abstract.

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