Topographic Aberrometric-Guided Photorefractive Keratectomy for Keratoconus With Accelerated Simultaneous Collagen Crosslinking Using High-Tech-Solution Laser
Narrative Responses:
Purpose
To assess the effectiveness of refractive error correction with corneal high order aberration(coma) selectively through a software using TAGCA Trans Epithelial PRK with Simultaneous Accelerated corneal collagen cross-linking to enhance the Visual Acuity in Keratoconus Patients
Methods
A- 30 progressive KC eyes with. Clear cornea,. Pachymeter ≤400µm, k reading ≥60 D. B- Trans Epithelial PRK Using software that incorporates RE, HOA and advanced eye tracking system so it won’t create refractive over correction. C- Followed immediately by CXL: using 20 minutes Riboflavin. Isotonic or Hypotonic Riboflavin depends on the corneal thickness to reach 400µm then emitting UVA light 18mW/cm² for 5 minutes. D- Mitomycin-c in a concentration of 0.02% for 20 sec post laser used in all cases.
Results
All eyes showed enhancement in their UDVA,CDVA,Q Value ,SE, Total High Order Aberration. No eyes showed Corneal Haze more than Grade 2. No over correction in all treated eyes. All eyes showed full stability and no progression in K reading.
Conclusion
Trans Epithelial PRK Treating Keratoconus by using refractive software in management of abnormal high order aberration, high Coma with Simultaneous Accelerated Corneal Collagen Cross-Linking appears to be safe and efficient in VA enhancement and rehabilitation in Keratoconus progression. Also it shows it’s a good alternative method to other modalities of Keratoconus Treatment.