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Long-term outcomes of combined topography-guided transepithelial photorefractive keratectomy and corneal collagen cross-linking for keratoconus

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Session Details

Session Title: Cross-Linking Protocols

Session Date/Time: Monday 24/09/2018 | 14:00-16:00

Paper Time: 14:46

Venue: Room A3, Podium 3

First Author: : P.Smahliou GREECE

Co Author(s): :    V. Mela                    

Abstract Details


To present the long-term results of combined topography guided transepithelial photorefractive keratectomy (topo-guided Trans PRK) followed simultaneously by corneal collagen cross linking (CXL) for the management of progressive keratoconus.


Smahliou Eye-Clinic, Athens, Greece


Visual and refractive outcomes of twenty-four patients (37 eyes of 25 males and 12 females) with progressive keratoconus, who underwent simultaneous topo-guided Trans PRK, combined with CXL were enrolled in the study. All patients were evaluated preoperatively and 6 months, 1, 3, and up to 7 years postoperatively. Postoperatively 37 eyes were evaluated at 6 months, 35 eyes at 1 and 3 years and 32 eyes at our last follow up at 7 years. Mean age of patients was 26,27 ± 3,67 years. No intraoperative or postoperative complications were occurred.


Mean uncorrected and corrected distance visual acuity were improved significantly from 0,77±0,31 (SD) logarithm of minimum angle of resolution (logMAR) and 0,28±0,21 logMAR preoperatively to 0,21±0,14 logMAR (p<0,001) and 0,12±0,10 logMAR (p<0,001) 7 years postoperatively, respectively. Mean steep K and flat K keratometry readings were significantly decreased from 49,15±4,39 diopters (D) and 45,05±3,15 D preoperatively to 44,22±4,25 D (p<0,001) and 42,60±4,01 D (p<0,001) 7 years postoperatively respectively. Mean corneal astigmatism and mean spherical equivalent improved significantly from -4,1±2,28 D and -3,97±3,23 D preoperatively to -1,62±1,69 D (p<0,001) and -1,52±2,54 D (p<0,001) at the last follow up respectively.


Combined topography guided Trans PRK followed simultaneously by CXL can be an effective and safe method for the management of keratoconic eyes, as refractive and topographic outcomes can be well improved after the surgical procedure in long term follow up.

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