Simultaneous PRK and CXL in Patients With Keratoconus Diagnosed After Rabinowitz-McDonnell Modified Criteria
Narrative Responses:
Purpose
Evaluate refractive improvement and keratometric stability at 12 and 18 months follow-up in 24 eyes with keratoconus diagnosed following Rabinowitz-McDonnell modified criteria, treated with simultaneous PRK and corneal collagen crosslinking.
Methods
Twenty-four eyes, M age 29, diagnosis keratoconus SimK >47.2D. Preoperative UCVA, BSCVA manifest, cicloplegic, Input refraction, keratometry K1 K2, pakimetry with TOMEY T5. PRK no mytomicin VISX STAR S4 IR EXCIMER LASER (AMO, Inc.) epithelium abrasion 9 mm. PAMPA NANO Nomo gram Input all cases: 70% treatment sphere 90% cylinder. Immediately Crosslinking performed same surgeon IROC UV-X 2000, 0.1% riboflavin 20% dextran solution instilled every 3 minutes 60 minutes, 10 minutes exposure to UV light, Wl 365 +/- 10 nm, 7.5 mm zone irradiance 9 mW/Cm2. Moxifluoxacin drops, bandage lens. Assessed daily first week, 3, 6, 12, 18 months postop. Retrospective
Results
Preoperative MSph -2,23D ±1,99 MCyl -3,52±0, 99 MSph Eq-3,66D. UCVA less than 20/80 all cases. BSCVA between 20/80-20/40. Mpakimetry 487 microns. MK1 51, 93D, and M K2 47,52D. MInput Sph -1,66D Cyl -3,54D, Mean Total Ablation Depth of 32,42 microns. Postoperative 18 months follow-up: M Sph -0,42D ±0,56 MCyl-0, 92D ± 0,88; MSphEq -0,58D. UCVA between 20/80-20/25 and BSCVA between 20/50-20/25 in all cases. Mean K1: 47,46D and M K2: 44,58D. Gain-loss of lines BSCVA (safety): no loss, the majority (66,7%) gained 2 and 5 lines (66,7%). No endothelial damage or haze.
Conclusion
Although more patients are needed, in terms of refractive improvement and stability of the keratoconus, PRK and Cross-Linking following the PAMPA NANO Nomo gram is a safe and effective procedure to treat patients with diagnosed keratoconus (p<0,01 T-Student test)).