Presentation on theme: "Topography-Guided Photorefractive Keratectomy (TG-PRK) for Keratoconus (KC) With Simultaneous Collagen Cross-Linking (CXL): Excimer Laser Simon Holland."— Presentation transcript:
1 Topography-Guided Photorefractive Keratectomy (TG-PRK) for Keratoconus (KC) With Simultaneous Collagen Cross-Linking (CXL): Excimer LaserSimon HollandDavid TC LinASCRS, Chicago, Illinois 2012*No financial interestsPurposeTo evaluate efficacy and safety of simultaneous TG-PRK for KC with simultaneous CXL1
2 Methods127 keratoconus eyes underwent treatment with Allegretto excimer laserTreatment targeted at post-op, with minimal residual stromal depth 300micronsEpithelial removal by trans-epithelial laserTopography-guided PRK, T-CAT software, modified by TNT (topographical neutralization)Riboflavin 0.1% in dextran, until aqueous stainingUV irradiation with riboflavin (up to 20 minutes)UV 370 um, 3mW/cm J/m2Hypotonic dextran if <400 umBandage contact lens, standard post PRKmanagement2
3 TG-PRK CXL for KERATOCONUS Pre-op: x months post-opBSCVA: 20/ UCVA: 20/30RX: x /25Glenn Tagulao3
9 Results 99 eyes completed 6 months follow-up 53 (54%) had ≥20/40 or better uncorrected visual acuity (UVA)92 (93%) had ≥20/40 or better best corrected visual acuity (BCVA)51 (52%) had BCVA improved, 32 (32%) improved BCVA 2 lines or more, 33 (33%) no change, 4 (4%) lost 2 lines or moreMean astigmatism decreased -2.77D pre-op to-1.14D4 had delay in epithelial healing with subsequent haze, 2 developed haze sufficient to reduce BCVA more than 2 lines, 1 had herpetic keratitis – 3 recovered pre-operative BCVA.Glare, halos, and difficulties with night driving decreased from 3.5 to 2.0 on a 4 point score (n=25)Dr.Holland, please verify the words in RED. Please make correction and put OK at end of each. Thanks!9
10 ConclusionsSimultaneous TG-PRK with CXL using customized TNT technique shows promise to improve both UCVA and BCVA in keratoconus patients with reasonable efficacy and safetyLonger term results are needed to establish value and safety of combining attempted refractive correction and topographical regularization with collagen cross linking10
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