Document Detail

Safety and efficacy of simultaneous corneal collagen cross-linking with topography-guided PRK in managing low-grade keratoconus: 1-year follow-up.
MedLine Citation:
PMID:  22443804     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To evaluate 1-year visual and topographic outcomes and safety and efficacy of corneal collagen cross-linking (CXL) combined with topography-guided photorefractive keratectomy (TG-PRK) to achieve near emmetropia in eyes with low-grade keratoconus.
METHODS: Twenty-two eyes from 15 patients (11 women, 4 men) were included in a prospective, nonrandomized, noncontrolled clinical study. Mean patient age was 26.6±6.07 years (range: 19 to 40 years). Inclusion criteria were low-grade keratoconus with evidence of progression, transparent cornea, corrected distance visual acuity (CDVA) 0.8 (decimal) or better, corneal thickness >440 μm, and maximum keratometry readings (K-max) <51.00 diopters (D). All patients underwent simultaneous TG-PRK with CXL. Study parameters were uncorrected distance visual acuity, CDVA, manifest refractive error, manifest and topographic (corneal) astigmatism, patient satisfaction, and efficacy and safety of the treatment. Follow-up was 1 year.
RESULTS: After 1 year, statistically significant improvement was noted in all study parameters (P<.01). The safety and efficacy indices were 1.6 and 0.4, respectively. Patient satisfaction questionnaire showed that 91% were satisfied, 9% were not completely satisfied but believed they improved, and none were dissatisfied. Corneal topography demonstrated significant improvement in 55%, improvement in 36%, and minor improvement in 9% of cases. No cases progressed as evidenced by keratometry readings.
CONCLUSIONS: Simultaneous TG-PRK with CXL is an effective and safe treatment with remarkable visual and topographic outcomes in patients with low-grade keratoconus who meet the recommended inclusion criteria.
Waleed S Tuwairqi; Mazen M Sinjab
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Publication Detail:
Type:  Journal Article     Date:  2012-03-26
Journal Detail:
Title:  Journal of refractive surgery (Thorofare, N.J. : 1995)     Volume:  28     ISSN:  1081-597X     ISO Abbreviation:  J Refract Surg     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-16     Completed Date:  2012-07-31     Revised Date:  2012-10-01    
Medline Journal Info:
Nlm Unique ID:  9505927     Medline TA:  J Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  341-5     Citation Subset:  IM    
Copyright Information:
Copyright 2012, SLACK Incorporated.
Elite Medical Center, Al Riyadh, Kingdom of Saudi Arabia.
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MeSH Terms
Collagen / metabolism*
Combined Modality Therapy
Corneal Stroma / metabolism*
Corneal Topography*
Cross-Linking Reagents / adverse effects,  therapeutic use*
Follow-Up Studies
Keratoconus / drug therapy,  metabolism,  surgery,  therapy*
Lasers, Excimer / therapeutic use*
Patient Satisfaction
Photorefractive Keratectomy*
Photosensitizing Agents / adverse effects,  therapeutic use
Prospective Studies
Refraction, Ocular / physiology
Riboflavin / adverse effects,  therapeutic use
Treatment Outcome
Visual Acuity / physiology
Young Adult
Reg. No./Substance:
0/Cross-Linking Reagents; 0/Photosensitizing Agents; 83-88-5/Riboflavin; 9007-34-5/Collagen
Comment In:
J Refract Surg. 2012 Sep;28(9):605; author reply 605   [PMID:  22947285 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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