Combined wavefront guided on the flap photorefractive keratectomy with accelerated collagen cross-linking for postlaser In situ keratomileusis ectasia: A novel technique

Abstract

Purpose: To report a series of patients who underwent simultaneous wavefront guided photorefractive keratectomy (PRK) followed by corneal collagen cross-linking (CXL) for post lasik ectasia. Methods: Two patients with corneal ectasia who underwent wavefront guided (iDesign Advanced Wave Scan Studio) PRK (STAR S4 IR ) immediately followed by CXL (AVEDRO) were included. Patient's Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, keratometry, pachymetry, corneal topography (Oculus Pentacam), were analyzed till 36 months of follow up. Results: 2 eyes had an improvement to UDVA of 20/20 at last follow-up. At 3 years follow up all the 2 eyes are topographically and visually stable maintaining 20/20. Conclusion: Simultaneous wavefront-guided PRK and CXL is effective and safe in achieving both visual quality improvement and topographic stability which is maintained in long term .This technique may offer an alternative and effective method to treat iatrogenic corneal ectasia.

Keywords

• combined photorefractive keratectomy with corneal cross-linking
• cross-linking
• ectasia
• iatrogenic ectasia
• laser in situ keratomileusis
• photorefractive keratectomy
• postlaser in situ keratomileusis ectasia