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Long-term comparison of combined transepithelial phototherapeutic keratectomy and corneal cross-linking vs corneal cross-linking with mechanical epithelial debridement for keratoconus

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Session Details

Session Title: Presented Poster Session: Cross-Linking

Venue: Poster Village: Pod 2

First Author: : M.Grentzelos GREECE

Co Author(s): :    D. Liakopoulos   G. Kontadakis   C. Siganos   M. Tsilimbaris   I. Pallikaris   G. Kymionis        

Abstract Details


To compare the long-term outcomes of corneal cross-linking (CXL) for the treatment of keratoconus using two different techniques for epithelial removal: transepithelial phototherapeutic keratectomy (t-PTK) versus mechanical epithelial debridement.


Vardinoyiannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece


In this prospective, comparative case series, twenty-six patients (30 eyes) with progressive keratoconus were enrolled. All patients underwent uneventful CXL treatment. Fifteen eyes (13 patients) underwent epithelial removal with t-PTK (group 1) and fifteen eyes (13 patients) underwent mechanical epithelial debridement (group 2) during CXL treatment. Visual, refractive and keratometric outcomes were evaluated. Follow-up was 4 years.


In group 1, LogMAR mean uncorrected distance visual acuity (UDVA) and mean corrected distance visual acuity (CDVA) improved from 0.99±0.42 and 0.33±0.28 preoperatively to 0.75±0.32 (p=0.018) and 0.21±0.16 (p=0.030) at 4 years postoperatively, respectively. In group 2, mean UDVA improved from 0.83±0.47 preoperatively to 0.63±0.40 (p=0.033), while CDVA did not demonstrate a statistically significant improvement at 4 years postoperatively (p>0.05). In group 1, mean corneal astigmatism improved from -6.19±4.54 (diopters; D) preoperatively to -4.68±3.10 D (p=0.041) at last follow-up, while in group 2 there was no statistically significant difference (p>0.05).


Epithelial removal with t-PTK during CXL resulted in better visual and refractive outcomes in comparison with mechanical epithelial debridement over a long-term follow-up.

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