Management of Post-LASIK Ectasia With Transepithelial CXL and Rigid Gas-Permeable Contact Lenses
Purpose
To compare transepithelial crosslinking (CXL) and rigid gas permeable contact lenses versus transepithelial CXL alone as conservative alternatives for management of post-LASIK ectasia.
Methods
Twenty-four eyes of 18 patients with post myopic LASIK ectasia, with mean uncorrected visual acuity (UCVA) 0.1, mean best corrected visual acuity (BCVA) of 0.3 and mean keratometry of 44.50 ± 0.4 D, patients had unsatisfying quality of vision and were refusing any surgical intervention. They were assigned into 2 groups; Group I of 10 eyes (8 patients) who received Riboflavin crosslinking with glasses prescription and Group II which included 14 eyes (10 patients) received Riboflavin crosslinking and fitted with rigid gas permeable contact lenses through 3 point touch technique to induce corneal flattening. Manufacturer: HW RGP Lab. Material: RGP 40% from Nissel Labs. UK. During 12 months, patients were followed up for UCVA, BCVA, Keratometry, patient satisfaction and (ORA). Complications were documented.
Results
Both groups showed stable keratometric readings, and better corneal biomechanics along the time of the study. In the first group the mean BCVA was (0.4), and poorer patient overall satisfactions in their quality of vision. In Group II RGP used: Trial set: 5.2 to 8.4 mm BC. Diameter: 8.7mm. Power of trial set: -4.0D added to correction done. Patients expressed higher index of overall satisfaction and achieved better visual acuity with a mean Of BCVA 0.9, corneal steepening improved in 4 eyes (28%). RGP contact lenses intolerance was reported by 2 patients (2 eyes: 14%). No complications were recorded from direct use of transepithelial riboflavin crosslinking or RGP contact lenses use along the study time.
Conclusion
Transepithelial crosslinking with rigid gas permeable contact lenses offer satisfying conservative options in patients with post-LASIK Ectasia regarding visual functions, patient satisfaction and overall safety profile.