Tags

Type your tag names separated by a space and hit enter

Comparison of sequential vs same-day simultaneous collagen cross-linking and topography-guided PRK for treatment of keratoconus.
J Refract Surg. 2009 Sep; 25(9):S812-8.JR

Abstract

PURPOSE

The safety and efficacy of corneal collagen cross-linking (CXL) and topography-guided photorefractive keratectomy (PRK) using a different sequence and timing were evaluated in consecutive keratoconus cases.

METHODS

This study included a total of 325 eyes with keratoconus. Eyes were divided into two groups. The first group (n=127 eyes) underwent CXL with subsequent topography-guided PRK performed 6 months later (sequential group) and the second group (n=198 eyes) underwent CXL and PRK in a combined procedure on the same day (simultaneous group). Statistical differences were examined for pre- to postoperative changes in uncorrected (UCVA, logMAR) and best-spectacle-corrected visual acuity (BSCVA, logMAR), manifest refraction spherical equivalent (MRSE), keratometry (K), topography, central corneal thickness, endothelial cell count, corneal haze, and ectatic progression. Mean follow-up was 36+/-18 months (range: 24 to 68 months).

RESULTS

At last follow-up in the sequential group, the mean UCVA improved from 0.9+/-0.3 logMAR to 0.49+/-0.25 logMAR, and mean BSCVA from 0.41+/-0.25 logMAR to 0.16+/-0.22 logMAR. Mean reduction in spherical equivalent refraction was 2.50+/-1.20 diopters (D), mean haze score was 1.2+/-0.5, and mean reduction in K was 2.75+/-1.30 D. In the simultaneous group, mean UCVA improved from 0.96+/-0.2 logMAR to 0.3+/-0.2 logMAR, and mean BSCVA from 0.39+/-0.3 logMAR to 0.11+/-0.16 logMAR. Mean reduction in spherical equivalent refraction was 3.20+/-1.40 D, mean haze score was 0.5+/-0.3, and mean reduction in K was 3.50+/-1.3 D. Endothelial cell count preoperatively and at last follow-up was unchanged (P<.05) in both groups. Statistically, the simultaneous group did better (P<.05) in all fields evaluated, with improvement in UCVA and BSCVA, a greater mean reduction in spherical equivalent refraction and keratometry, and less corneal haze.

CONCLUSIONS

Same-day simultaneous topography-guided PRK and CXL appears to be superior to sequential CXL with later PRK in the visual rehabilitation of progressing keratoconus.

Authors+Show Affiliations

Laservision.gr Institute, Athens, Greece; New York University Medical College and Manhattan Eye, EAr and Throat Hospital, New York, NY, USA. ajk@brilliantvision.com

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19772257

Citation

Kanellopoulos, Anastasios John. "Comparison of Sequential Vs Same-day Simultaneous Collagen Cross-linking and Topography-guided PRK for Treatment of Keratoconus." Journal of Refractive Surgery (Thorofare, N.J. : 1995), vol. 25, no. 9, 2009, pp. S812-8.
Kanellopoulos AJ. Comparison of sequential vs same-day simultaneous collagen cross-linking and topography-guided PRK for treatment of keratoconus. J Refract Surg. 2009;25(9):S812-8.
Kanellopoulos, A. J. (2009). Comparison of sequential vs same-day simultaneous collagen cross-linking and topography-guided PRK for treatment of keratoconus. Journal of Refractive Surgery (Thorofare, N.J. : 1995), 25(9), S812-8. https://doi.org/10.3928/1081597X-20090813-10
Kanellopoulos AJ. Comparison of Sequential Vs Same-day Simultaneous Collagen Cross-linking and Topography-guided PRK for Treatment of Keratoconus. J Refract Surg. 2009;25(9):S812-8. PubMed PMID: 19772257.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of sequential vs same-day simultaneous collagen cross-linking and topography-guided PRK for treatment of keratoconus. A1 - Kanellopoulos,Anastasios John, Y1 - 2009/09/11/ PY - 2009/9/24/entrez PY - 2009/9/24/pubmed PY - 2009/12/16/medline SP - S812 EP - 8 JF - Journal of refractive surgery (Thorofare, N.J. : 1995) JO - J Refract Surg VL - 25 IS - 9 N2 - PURPOSE: The safety and efficacy of corneal collagen cross-linking (CXL) and topography-guided photorefractive keratectomy (PRK) using a different sequence and timing were evaluated in consecutive keratoconus cases. METHODS: This study included a total of 325 eyes with keratoconus. Eyes were divided into two groups. The first group (n=127 eyes) underwent CXL with subsequent topography-guided PRK performed 6 months later (sequential group) and the second group (n=198 eyes) underwent CXL and PRK in a combined procedure on the same day (simultaneous group). Statistical differences were examined for pre- to postoperative changes in uncorrected (UCVA, logMAR) and best-spectacle-corrected visual acuity (BSCVA, logMAR), manifest refraction spherical equivalent (MRSE), keratometry (K), topography, central corneal thickness, endothelial cell count, corneal haze, and ectatic progression. Mean follow-up was 36+/-18 months (range: 24 to 68 months). RESULTS: At last follow-up in the sequential group, the mean UCVA improved from 0.9+/-0.3 logMAR to 0.49+/-0.25 logMAR, and mean BSCVA from 0.41+/-0.25 logMAR to 0.16+/-0.22 logMAR. Mean reduction in spherical equivalent refraction was 2.50+/-1.20 diopters (D), mean haze score was 1.2+/-0.5, and mean reduction in K was 2.75+/-1.30 D. In the simultaneous group, mean UCVA improved from 0.96+/-0.2 logMAR to 0.3+/-0.2 logMAR, and mean BSCVA from 0.39+/-0.3 logMAR to 0.11+/-0.16 logMAR. Mean reduction in spherical equivalent refraction was 3.20+/-1.40 D, mean haze score was 0.5+/-0.3, and mean reduction in K was 3.50+/-1.3 D. Endothelial cell count preoperatively and at last follow-up was unchanged (P<.05) in both groups. Statistically, the simultaneous group did better (P<.05) in all fields evaluated, with improvement in UCVA and BSCVA, a greater mean reduction in spherical equivalent refraction and keratometry, and less corneal haze. CONCLUSIONS: Same-day simultaneous topography-guided PRK and CXL appears to be superior to sequential CXL with later PRK in the visual rehabilitation of progressing keratoconus. SN - 1081-597X UR - https://www.unboundmedicine.com/medline/citation/19772257/Comparison_of_sequential_vs_same_day_simultaneous_collagen_cross_linking_and_topography_guided_PRK_for_treatment_of_keratoconus_ L2 - https://www.healio.com/doiresolver?doi=10.3928/1081597X-20090813-10 DB - PRIME DP - Unbound Medicine ER -