Combined Same-Day Femtosecond Laser-Assisted ICRS and Transepithelial Fast CXL for Keratoconus

Correa, Rosane

Combined Same-Day Femtosecond Laser-Assisted ICRS and Transepithelial Fast CXL for Keratoconus

Friday, April 25, 2014

KIOSKS (Boston Convention and Exhibition Center)

Rosane Correa, MD, Rio de Janeiro Corneal Tomography and Biomechanical Study Group, Rio de Janeiro, Brazil

Rodrigo T. Santos, MD, Rio de Janeiro Corneal Tomograhyand Biomechanics Study Group, SAO JOSE DOS CAMPOS, Brazil

Ana Laura C. Canedo, MD, VisareRio, Rio de Janeiro, Brazil

Marcella Salomão, MD, Barra Vision Center, Rio de Janeiro, Brazil

Bruno F. Valbon, MD, University of São Paulo, Niterói, Brazil

Renato Ambrósio Jr., MD, PhD, Inst. Olhos R. Ambrósio, Rio de Janeiro, Brazil

Narrative Responses:

Purpose
To evaluate visual acuity, keratometric readings and corneal thickness after femtosecond laser (FS)-assisted intrastromal corneal ring segment implantation (ICRS) and transepithelial fast corneal cross-linking (CXL) performed at the same day in keratoconic eyes.

Methods
14 eyes of 10 patients diagnosed with progressive keratoconus were included. UCVA, BSCVA, mean keratometry (Kmean), maximal keratometry (Kmax), corneal astigmatism and corneal thickness at the thinnest point (TP) were taken preoperatively and postoperatively at 1, 3 and 6 months of follow-up using Pentacam HR All eyes underwent intrastromal corneal ring segment implantation using Femtosecond laser to create the channel followed by transepithelial fast corneal cross-linking. Preoperatively, average UCVA and BSCVA in LogMar were 1and 0.6 respectively. Kmean, Kmax and corneal astigmatism were 51.8 D, 62.4 D and 3.6 D, respectively. Corneal thickness at the thinnest point was 442 µm.

Results
Average UCVA and BSCVA improved at least 1 line of vision in 66% of eyes at 1 and 6-month follow-up. All eyes (3 eyes) improved visual acuity (UCVA and BSCVA) in 3 months of follow-up. BSCVA improved or remained stable in 66.6% and 33.3% of eyes in each follow-up. Average UCVA and BSCVA in LogMar were 1 and 0.4 at 6-month follow-up, respectively. Kmean, Kmax, corneal astigmatism and corneal thickness at thinnest point declined to 51 D, 60 D, 2.3 D and 403 µm after 6-month visit. One year results will be presented.

Conclusion
Combined, same day FS-assisted ICRS and fast transepithelial provided significant improvement on visual acuity and corneal shape. CXLast This technique seems to be at least as safe and effective as FS-assisted ICRS procedure to halt progressive keratoconus and make the corneal shape less irregular.