Сравнительная оценка результатов комбинированного применения различных методов лечения: кросслинкинга роговицы, имплантации интрастромальных роговичных колец-сегментов и трансэпителиальной топографической фоторефрактивной кератэктомии при лечении кератоконуса

Abstract

Purpose. Comparative evaluation of the results of combined use of corneal cross-linking (CXL) and implantation of intrastromal corneal ring segments (ICRS) followed by transepithelial topographic photorefractive keratectomy (ТE-topoPRK) in the treatment of keratoconus. Material and methods. The study had been conducted at the National Centre of Ophthalmology named after acad. Zarifa Aliyeva. Within the frames of the first stage of the study during 2016–2019 years: 48 patients (48 eyes) have been operated only with using CXL (first group); 48 patients (48 eyes) – with using only ICRS (second group); and 48 patients (48 eyes) – with using of combination of CXL and ICRS (ICRS first, then CXL after 24 hours) for treatment of keratoconus of II–III stages due to Amsler M. classification. After 8 months, all patients (144 eyes) underwent the second stage of treatment using ТE-topoPRK. Results. Visual acuity and corneal status 8 months later after CXL, ICRS and the combination of CXL with ICRS generally changed significantly, which confirms the achievement of the expected effect. Comparing the studied parameters after the operation in the groups of patients operated on by the CXL, ICRS methods and their combination, a significant difference was revealed only in the value of NCVA (0.22±0.04, 0.46±0.03 и 0.52±0.04; р<0.05). Conclusion. The combined two-stage (with the interval of 8 months) treatment of keratoconus by implantation of intrastromal corneal rings with simultaneous corneal crosslinking followed by topographic photorefractive keratectomy is more effective than the use of these operations without combinations. Key words: crosslinking, corneal segments, keratoconus, topographic photorefractive keratectomy