Initial Clinical Experience of Topography Customized CXL Applications for Myopic, Hyperopic, and Presbyopic Refractive Corneal Change
Narrative Responses:
Purpose
To evaluate the safety and efficacy of very high fluence, topography customized CXL (PiXL) treatments.
Methods
A total of 23 cases (12 for myopic and 11 for hyperopic) were subjected to PiXL procedure using excimer laser epithelial removal, 0.25% riboflavin solution soaking and 12Joules total UV energy applied for CXL. We evaluated pre-operatively and 1, 3, 6 months postoperatively for visual acuity, keratometry, cornea clarity and scatter, topography (Placido disc, Scheimpflug), as well.
Results
In the myopic cases, an average of 2.2 diopters of central corneal flattening was documented, with no endothelial or clarity changes. In the hyperopic cases, an average of 2.1 diopters of central corneal steepening was documented, with no endothelial or clarity changes. There was a slight regression of 1 diopter regression of the effect within the first month, that appeared stable thereafter.
Conclusion
The novel PiXL procedure appears safe and effective in significant myopic and hyperopic corrective changes without the need of corneal stroma tissue removal. In the case of hyperopic treatments, these changes may aid with presbyopic vision as well. Longer follow-up and further studies may be needed to refine the dose-effect nomogram and further validate these findings.