Analysis of Our Results With Accelerated CXL in Laser Vision Correction

Tuesday, April 21, 2015: 8:51 AM
Room 1B (San Diego Convention Center)
Chitra R. Ramamurthy, MD
Ramamurthy Dandapani, MD
Shreyas Ramamurthy, MD

The aim of this retrospective study is to evaluate the results of 30 eyes of 15 patients who underwent CXL with PRK and intralase. This analysis was further compared with 50 eyes of 25 patients who underwent routine transepithelial PRK without CXL.

30 eyes of 15 patients aged 20 – 36 yrs were analyzed following LVC and CXL with 0.25% riboflavin application & exposure of 30 mw/cm2 UV irradiation and 6 months follow-up. 14 eyes had suspicious topography. 4 eyes had scissoring reflex and corneal asymmetry, 2 eyes forme fruste KC.  The refractive error ranged from -0.50 D sph to -14 D sph and -0.50 D dcyl to -5.50 D cyl. The preop CCT values ranged 455 to 558 µ. The predictability, safety and efficacy of the procedure and the visual outcomes were measured. 50 eyes of 25 patients who underwent routine transepithelial PRK without cxl in the same age group and follow-up were compared. The refractive error and CCT were in a similar range.

Residual refractive error ranged from -0.25D cyl to -0.75D cyl in 4 eyes which was gratifying keeping in mind the refractive range treated and limited CCT. 100% maintained BCVA. 73% had predictable residual beds. Corneal flattening irrespective of the refractive correction, ranged from 0.55 D to 1.9 D in 3 mm zone in 20% and 0.45 D to 1.0 D in 5mm zone in 10%. No haze was noted in the follow up visits. Residual refractive error in the routine PRK group ranged from +0.75 to -0.50D sph eq in 2 eyes. 98% maintained BCVA. 100% maintained predicted residual bed. No haze was noted in the follow up visits and flattening in the 3mm and 5mm zone were respective to the refractive error corrected.

Crosslinking in suspicious topographies in laser vision correction without a commensurate refractive change augurs for a better biomechanical integrity and hysteresis and  a predictable refractive accuracy.