5-year efficacy of all surface laser ablation with cross-linking (ASLA-XTRA) for the treatment of myopia

Ioannis M Aslanides; Farhad Hafezi; Shihao Chen; Hatch Mukherjee; Vasileios Selimis; Ilias Maragkos; Nanji Lu; George Kymionis

doi:10.1186/s40662-020-00198-z

5-year efficacy of all surface laser ablation with cross-linking (ASLA-XTRA) for the treatment of myopia

Eye Vis (Lond). 2020 Jun 11:7:31. doi: 10.1186/s40662-020-00198-z. eCollection 2020.

Authors

Ioannis M Aslanides^{1

2}, Farhad Hafezi^{2

3

4

5

6}, Shihao Chen², Hatch Mukherjee⁷, Vasileios Selimis¹, Ilias Maragkos¹, Nanji Lu^{1

2}, George Kymionis^{8

9}

Affiliations

¹ Emmetropia Mediterranean Eye Institute, Plateia Eleftherias 44, Heraklion, 71201 Crete, Greece.
² Eye Hospital, Wenzhou Medical University, Wenzhou, China.
³ Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Dietikon/Zurich, Switzerland.
⁴ ELZA Institute, Dietikon/Zurich, Switzerland.
⁵ USC Roski Eye Institute, University of Southern California, California, Los Angeles USA.
⁶ Faculty of Medicine, University of Geneva, Geneva, Switzerland.
⁷ Essex County Hospital, Essex, UK.
⁸ Athens Medical School, University of Athens, Athens, Greece.
⁹ Faculty of Biology and Medicine, Jules Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.

Abstract

Background: The purpose of our study is to examine the long (5-year) efficacy of the all surface laser ablation (ASLA) combined with accelerated cross-linking (CXL) for the treatment of myopia without the use of mitomycin-C (MMC).

Methods: This retrospective study consisted of 202 eyes of 118 myopic (SD: 2.41, range: - 1.50 to - 12.75 D) patients (44 males, 74 females). Mean age was 28.50 years (SD: 6.45, range: 18 to 51 years) that underwent ASLA with accelerated CXL for the treatment of their myopia.

Results: The patients underwent routine postoperative assessment on the 1st, 3rd, 7th day and in the 1st, 3rd, 6th and 12th month, 30th month (±6 months), 4th and 5th year. The mean spherical equivalent (SEq) refractive error changed from - 6.41 ± 2.41 D preoperatively to - 0.02 ± 0.53 D at 5 years postoperatively. The haze score was 0.18, 0.25 and 0.28 at 1, 3 and 6 months postoperatively. At 12 months after the treatment, no eyes had significant corneal haze and in all the following postoperative time intervals the haze traces were gone.

Conclusion: ASLA combined with accelerated CXL (ASLA-XTRA) appears to be safe, efficacious and offering very good refractive results. The potential additional benefits of this modality are the stabilizing effect of the refraction and its sterilization effect on the treated cornea without the potential side effects of MMC.

Keywords: ASLA; ASLA-XTRA; CXL; Cross-linking; PRK; Refractive surgery; Transepithelial.