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High-resolution wavefront-guided surface ablation with corneal cross-linking in ectatic corneas: a pilot study

Authors Tamayo GE, Castell C, Vargas P, Polania E, Tamayo J

Received 27 April 2017

Accepted for publication 11 July 2017

Published 3 October 2017 Volume 2017:11 Pages 1777—1783

DOI https://doi.org/10.2147/OPTH.S140627

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Gustavo E Tamayo, Claudia Castell, Pilar Vargas, Eduardo Polania, Juliana Tamayo

Bogota Laser Ocular Surgery Center, Bogota, Colombia

Purpose: A preliminary study to evaluate the outcomes of high-resolution wavefront-guided (HRWG) photorefractive keratectomy (PRK) with simultaneous corneal cross-linking (CXL) in ectasia eyes.
Methods: Sixteen eyes of 11 patients (mean age 31.9±9.8 years; range: 15–48 years) with keratoconus or post-laser-assisted in situ keratomileusis ectasia underwent HRWG PRK with simultaneous CXL. Manifest refraction, uncorrected (UDVA) and corrected distance visual acuity (CDVA), and keratometric and aberrometric outcomes are reported at 12 months.
Results: Significant improvement was observed postoperatively in visual acuity, refraction, and keratectomy in all eyes. At postoperative 12 months, 87.5% eyes were within ±1.0 D of attempted correction and 81.25% of eyes had a postoperative UDVA of 20/32 or better. A gain of 2 or more lines of CDVA was observed in 12.5% (2/16) of eyes and there was no change in CDVA lines in 25% (4/16) eyes. A substantial reduction in higher-order aberrations was observed in all eyes postoperatively; however, the improvement was not statistically significant.
Conclusion: The outcomes of HRWG PRK in ectasia eyes with estimated residual stromal bed thickness of at least 350 µm (without epithelium) are promising at postoperative 1 year and provide surgeons with a valuable tool to improve vision with a high degree of refractive predictability.

Keywords: wavefront ablation, corneal cross linking, irregular astigmatism, keratoconus, ectasia

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