ESCRS - PP20.12 - Long-Term Results Of Simultaneous Transepithelial Phototherapeutic Keratectomy And Conventional Photorefractive Keratectomy (Cretan Protocol Plus) Followed By Corneal Crosslinking For Keratoconus

Long-Term Results Of Simultaneous Transepithelial Phototherapeutic Keratectomy And Conventional Photorefractive Keratectomy (Cretan Protocol Plus) Followed By Corneal Crosslinking For Keratoconus

Published 2022 - 40th Congress of the ESCRS

Reference: PP20.12 | Type: ESCRS 2022 - Posters | DOI: 10.82333/xvqc-5350

Authors: Dimitrios Liakopoulos* 1 , Michael Grentzelos 2 , Athanasios Economou 3 , Charalambos Siganos 1 , Miltiadis Tsilimbaris 4 , Ioannis Pallikaris 4 , George Kymionis 5

1Laboratory of Vision and Optics (LVO) – Vardinoyiannion Eye Institute of Crete (VEIC), School of Medicine, University of Crete,Heraklion,Greece, 2Laboratory of Vision and Optics (LVO) – Vardinoyiannion Eye Institute of Crete (VEIC), School of Medicine, University of Crete,Heraklion,Greece;Epsom and St Helier, University Hospitals, NHS Trust,Surrey,United Kingdom, 3Ophthalmology Department of Central Medical Office of Thessaloniki Police Association,Thessaloniki,Greece, 4Laboratory of Vision and Optics (LVO) – Vardinoyiannion Eye Institute of Crete (VEIC), School of Medicine, University of Crete, Heraklion,Greece, 5Department of Ophthalmology, Faculty of Medicine, University of Athens,Athens,Greece

Purpose

To present the long-term visual, refractive, and topographic outcomes after combined transepithelial phototherapeutic keratectomy (t-PTK) and conventional photorefractive keratectomy (PRK) followed simultaneously by corneal crosslinking (CXL) for keratoconus.

Setting

Laboratory of Vision and Optics (LVO) – Vardinoyiannion Eye Institute of Crete (VEIC), School of Medicine, University of Crete, Heraklion, Crete, Greece

Methods

Patients with progressive keratoconus had simultaneous conventional PRK followed by CXL; the corneal epithelium was removed using transepithelial PTK (Cretan protocol plus).

Results

Twenty-five patients (37 eyes) were enrolled. Mean follow-up was 7.62 years (range: 6 to 10 years).  The mean uncorrected and corrected distance visual acuity improved significantly from 0.80±0.38 (SD) logarithm of minimum angle of resolution (logMAR) and 0.18±0.19 logMAR preoperatively to 0.42±0.30 logMAR (P<.001) and 0.06±0.11 logMAR (P<.001) at last follow-up postoperatively, respectively.The mean spherical equivalent improved significantly from -5.08±4.59 diopters (D) preoperatively to -2.29±2.45 D (P<.001) at last follow-up. The mean steep keratometry and flat keratometry readings decreased significantly from 50.03±4.04 D and 45.84±2.73 D preoperatively to 45.95±3.19 D (P<.001) and 43.38±2.72 D (P<.001) at last follow-up, respectively.

Conclusions

Combined transepithelial PTK and conventional PRK followed simultaneously by CXL was effective in corneal stabilization and vision improvement in keratoconic patients.