Combined topography-guided photorefractive keratectomy and corneal collagen crosslinking

K Kiran Kumar; Spurti Nataraj; Vandana Maganty; Kinjal H Porwal; Suresh B Gangasagara

doi:10.4103/IJO.IJO_791_23

Combined topography-guided photorefractive keratectomy and corneal collagen crosslinking

Indian J Ophthalmol. 2024 May 20. doi: 10.4103/IJO.IJO_791_23. Online ahead of print.

Authors

K Kiran Kumar¹, Spurti Nataraj, Vandana Maganty, Kinjal H Porwal, Suresh B Gangasagara

Affiliation

¹ Department of Ophthalmology, Minto Ophthalmic Hospital, Regional Institute of Ophthalmology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.

PMID: 38767551
DOI: 10.4103/IJO.IJO_791_23

Abstract

Purpose: This study aimed to report the long-term results of combined topography-guided photorefractive keratectomy (PRK) and accelerated corneal collagen cross-linking (CXL) for keratoconus using the Zeiss refractive coordinated system.

Methods: A prospective interventional study was conducted in a tertiary eye care hospital in South India. Patients with mild-to-moderate progressive keratoconus and corneal pachymetry greater than 450 μm were included. They underwent customized topography-guided PRK followed by CXL. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and keratometry readings and complications were evaluated at 1, 3, 6, 12, and 24 months postoperatively.

Results: Thirty patients (30 eyes) were included in the study. All study parameters showed a statistically significant improvement postoperatively over baseline values. At 24 months, the mean UDVA improved from 0.8 ± 0.180 logarithm of the minimum angle of resolution (logMAR) to 0.38 ± 0.118 logMAR ( P -value <0.001) and CDVA improved from 0.467 ± 0.142 logMAR to 0.227 ± 0.078 logMAR ( P -value <0.001). The mean flat, steep, and maximum keratometry values were significantly reduced by 2.133, 3, and 4.54 diopters, respectively, at the last follow-up examination ( P -value <0.001).

Conclusion: The combined topography-guided PRK and accelerated CXL procedure seem to be a promising treatment alternative for early keratoconus. This is the first such study on the Zeiss refractive coordinated system. However, further studies with a larger study population and longer follow-up periods are required to draw final conclusions about the benefits of this procedure in keratoconus.