Refractive meridional corneal collagen cross-linking: a new modified technique for treatment of astigmatism

Abstract

Purpose The aim of the study was to evaluate the efficacy and safety of using corneal collagen cross-linking as a refractive procedure to correct corneal astigmatism. Setting This study was conducted in Sohag University Hospital (Egypt). Design This is a prospective, nonrandomized, clinical trial study. Patients and methods Fifteen eyes of 11 patients complaining of astigmatism were treated with refractive meridional cross-linking (RMCXL). Group A included eight eyes that had undergone previous cross-linking and implantation of intracorneal rings that failed to correct the astigmatic component of keratoconus. Group B included seven eyes with astigmatism without corneal ectasia. All eyes were subjected to examination of the preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and manifest refraction, as well as slit lamp examination of the anterior segment, keratometry, and pachymetry by corneal topographies at 1 week and at 1, 3, and 6 months' follow-up. Results In group A, the preoperative mean UDVA was 0.90 ± 0.33 (log MAR ± SD), whereas the postoperative mean UDVA was 0.78 ± 0.27. The preoperative mean CDVA was 0.60 ± 0.38, whereas the postoperative mean CDVA was 0.48 ± 0.26. The mean postoperative astigmatic correction was 1.8 ± 0.36. In group B, the preoperative mean UDVA was 0.78 ± 0.53, whereas the postoperative mean UDVA was 0.52 ± 0.23. The preoperative mean CDVA was 0.52 ± 0.26, whereas the postoperative mean CDVA was 0.30 ± 0.15. The mean postoperative astigmatic correction was 0.90 ± 0.29. Conclusion RMCXL showed good refractive correction for astigmatism in both ectatic and nonectatic corneas. RMCXL proved to be a promising new simple, effective, and safe procedure for the treatment of corneal astigmatism with reasonable patient satisfaction.