Femtosecond-Assisted Myopic LASIK: Long-Term Comparison of LASIK Combined With Prophylactic CXL and Standard LASIK
Purpose
To evaluate safety, efficacy, and refractive, keratometric and epithelial stability of myopic femtosecond-LASIK with concurrent prophylactic CXL in comparison to standard femtosecond LASIK.
Methods
One-hunder forty eyes of consecutive patients with myopic LASIK were recruited. Group-A represents 65 eyes treated additionally with concurrent prophylactic high fluence CXL (LASIK-CXL); group-B represents 75 eyes subjected to stand-alone procedure. The following parameters were evaluated preoperatively and one-year postoperatively: manifest refractive spherical error (MRSE), refractive astigmatism, spectacle-corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), corneal keratometry via Scheimpflug imaging, autorefraction keratometry and epithelial mapping with anterior segment OCT.
Results
Group-A post refraction average -0.25 D at 12-months, compared to -6.75±1.75 D preoperatively. SteepK was 38.37 D at 12-months, compared to 45.15 D preoperatively. Predictability had a correlation coefficient of 0.975. The mid-peripheral epithelial thickness increase was +3.79μm and +3.95μm for the (-8.00D to -9.00D) and (-7.00D to -8.00D) subgroups, which compare to increased thickness in group-B, of +9.75μm (p = 0.032) and +7.14μm (p = 0.041), respectively. Group-B post refraction average: -0.27 D at 12-months, compared to -5.33±2.34 D preoperatively. SteepK was 38.66 D at 12-months, compared to 44.03 D preoperatively. Predictability had a correlation coefficient of 0.968.
Conclusion
Application of prophylactic cross-linking concurrently with high-myopic LASIK operation appears to contribute to improved refractive, keratometric stability and epithelial profiles in comparison to the stand-alone LASIK.