Abstract
To evaluate the one year visual and tomographic results of customized cross-linking using excimer laser assisted epithelium removal and topography-guided irradiation in the treatment of progressive keratoconus. Coimbra Ophthalmology Unit. Private practice. Coimbra, Portugal. Prospective non-randomized clinical trial. Eyes with documented progressive keratoconus were enrolled. Following de-epithelization with PTK, customized UV irradiation was performed, designed as 3 concentric circular areas centered on the thinnest point (Mosaic System, Avedro, USA). Energy exposure was 5.4J/cm2 in the outer circle and then increased centripetally to 7.2 J/cm2 and 10 J/cm2 . Corrected distance visual acuity (CDVA), refractive outcomes, and Scheimpflug tomographies (Allegro Oculyzer (WaveLight, Germany) were assessed at baseline, and 6 and 12 months postoperatively. This prospective study enrolled 37 eyes of 32 patients. Mean diameter for treated areas was 6.17 ± 0.80, 4.45 ± 0.47, and 2.58 ± 0.14 mm for the outer, medium, and inner circle, respectively. At the 1 year follow-up, mean CDVA improved significantly from 0.38 ± 0.19 to 0.20 ± 0.16 logMAR (p<0.01), with 34 of the 37 eyes (91.89%) retaining or improving CDVA. Mean pre-operative minimum pachimetry decreased from 449.26 ± 41.62 μm to 443.26 ± 41.06 μm (p=0.02). The maximal curvature (Kmax) decreased significantly from 58.50 ± 7.84 D to 57.05 ± 7.27 D (p<0.01). After 1 year, 34 eyes (91.89%) showed no signs of progression. One year after surgery, patients showed a significant improvement in visual acuity while achieving stabilization of disease progression.
Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
