New Microwave Thermokeratoplasty and Accelerated CXL for the Keratoconus: Results in 24 Eyes During 1 Year of Follow-up
Purpose
To evaluate the safety and efficacy of a new microwave thermokeratoplasty procedure combined with accelerated corneal cross-linking for the improvement of visual function in subjects with keratoconus.
Methods
This prospective study was performed on 24 keratoconic eyes of 24 participants, aged 18 to 45 years. Participants of the study were followed for 12 months. The attempted corrections ranged from -1.60D to -6.50D. The main outcome measures were changes in LogMAR values of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA) and in keratometry values.
Results
The mean preoperative UDVA (0.66 ±0.26) significantly improved to 0.39 ±0.21 at one month. However by postoperative month 6, mean UDVA had regressed to 0.58 ±0.21.At postoperative month 12, mean UDVA was 0.62 ±0.17. Keratometry values had a preoperative mean of 49.11 ±2.43D, compared to the following postoperative values: 43.50 ±3.04D at 1 month, 45.7 ±3.25D at 3 months, 47.52 ±2.99D at 6 months, 48.25 ±3.02D at 9 month and 48.37 ±3.00D at 12 months. Mean preoperative endothelial cell density (2610 ±283 cells/mm2) was similar at postoperative month 12(2595 ±297 cell/mm2). No patient exhibited line loss in CDVA by postoperative month 12.
Conclusion
The new thermokeratoplasty procedure described in this study followed by accelerated corneal cross-linking produced the desired reduction of keratometry values and improvement in postoperative UCVA without significant side effects. However, the early and complete regression of the thermokeratoplasty effect demonstrated the need for further advancement in this technology.