Simultaneous Photo Ablation And Crosslinking Treatment In Moderate Progressive Keratoconus

The management of Keratoconus is increasingly refractive 

The understanding of optical aberrations, the mastery of aberrated guide PRK and the efficiency of Crosslinking have allowed the stabilization of Keratoconus and the improvement of the best corrected visual acuity

 

All patients with moderate Keratoconus whose evolution has been confirmed will benefit from a complete  medical checkup of the cornea with Tomography ,OCT of the cornea aberrometry

When managing Keratoconus, we have proceeded  in 4 steps in our series of 48 patients suffering from an evolving keratoconus; and this was done after having performed a complete checkup to  confirm the existence of  keratoconus, its stage and its evolution

our methodology based on 4 steps:

Step 1

Simulation of the PTK aberroguided photo ablation profile on the ZYWAVE machine based on the minimal  pachymetry and the minimal epithelial pachymetry respecting the maximum ablation of 50 microns and a residual stromal bed superior to 350 microns

 Step 2

epithelium removal by PTK on a 7 mm area  

 Step 3

PHOTO ABLATION PRK aberro guided never exceeding 50 microns on a 6.5 mm area

 Step 4 

Crosslinking by an accelerated Dresden protocol

A complete postoperative TOMO OCT ABERRO assessment  is performed over the periods of  3, 6  and 12 months after treatment .

The monitoring elements are BCVA, K max, HOA

We notice  an improvement of the three monitoring parameters in more than 80% of the cases after which  a follow-up of 12 months  is done.

The combined and simultaneous treatment by photo ablation and CXL gives a stability of the keratoconus and an improvement of the best corrected visual acuity