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Better results seen with same-day corneal collagen cross-linking and PRK
J Refract Surg. 2009;25(9):812-818.
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Corneal collagen cross-linking and topography-guided PRK for keratoconus appeared to be more effective when performed on the same day rather than sequentially, a study showed.
"Statistically, the simultaneous group did better in all fields evaluated, with improvement in [uncorrected visual acuity and best corrected visual acuity], a greater mean reduction in spherical equivalent refraction and keratometry, and less corneal haze," the study authors said.
The study included 325 eyes with keratoconus. One group of 127 eyes underwent cross-linking and PRK 6 months later. A second group of 198 eyes underwent both procedures on the same day.
Investigators evaluated logMAR UCVA and BCVA, manifest refraction spherical equivalent, keratometry, topography, central corneal thickness, endothelial cell count, corneal haze and progression of corneal ectasia. The mean follow-up interval was 36 months.
Among patients who underwent cross-linking with delayed PRK, mean logMAR UCVA improved from 0.9 to 0.49 and mean BCVA improved from 0.41 to 0.16. The group had a mean reduction in spherical equivalent refraction of 2.50 D and a mean reduction in keratometry of 2.75 D. The mean haze score was 1.2.
Mean UCVA of patients who underwent same-day cross-linking and PRK improved from 0.96 to 0.3 logMAR. Mean BCVA improved from 0.39 to 0.11 logMAR. The group had a mean reduction in spherical equivalent refraction of 3.20 D and a mean reduction in keratometry of 3.50 D. The patients had a mean haze score of 0.5.
Neither group showed a change in endothelial cell count.