Corneal collagen crosslinking in post-LASIK keratectasia

Br J Ophthalmol. 2011 Apr;95(4):493-7. doi: 10.1136/bjo.2010.179424. Epub 2010 Aug 1.

Abstract

Background/aims: To evaluate the effect of corneal collagen crosslinking with riboflavin and UV-A as a treatment option for postlaser in situ keratomileusis keratectasia.

Methods: Crosslinking was carried out in 22 eyes of 15 patients with iatrogenic keratectasia. Follow-up, according to a standardised protocol (uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), slit-lamp examination, pachymetry and topography), was performed preoperatively 1, 3, 6 and 12 months after crosslinking.

Results: The mean BCVA was 0.19 (SD ± 0.21) logMAR preoperatively, 0.25 (SD ± 0.17) 1 month, 0.20 (SD ± 0.20) 3 months, 0.18 (SD ± 0.21) 6 months and 0.15 (SD ± 0.14) 12 months postoperatively (statistically significant postop1-postop6, p=0.0335). The maximum k-readings were 44.12 (SD ± 3.97) preoperatively, 46.23 (SD ± 4.14) 1 month, 43.88 (SD ± 4.25) 3 months, 45.06 (SD ± 5.07) 6 months and 44.43 (SD ± 4.06) 12 months postoperatively (statistically significant preop-postop1, p=0.0281).

Conclusion: Crosslinking in patients with iatrogenic keratectasia stabilised the UCVA and BCVA as well as the maximum k-readings in our cohort. It seems to be a safe and promising procedure to stabilise the refraction and the corneal topography, and thus to stop the progression of visual loss, thereby avoiding or delaying disease progression and keratoplasty.

MeSH terms

  • Adult
  • Collagen / therapeutic use*
  • Corneal Diseases / drug therapy*
  • Cross-Linking Reagents / therapeutic use*
  • Female
  • Humans
  • Keratomileusis, Laser In Situ / adverse effects*
  • Male
  • Middle Aged
  • Myopia / physiopathology
  • Myopia / therapy
  • Photosensitizing Agents / therapeutic use*
  • Postoperative Period
  • Prospective Studies
  • Riboflavin / therapeutic use*
  • Ultraviolet Therapy / methods*
  • Visual Acuity / physiology

Substances

  • Cross-Linking Reagents
  • Photosensitizing Agents
  • Collagen
  • Riboflavin