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Clinicians debate consecutive vs. simultaneous crosslinking, PRK
 John A. Kanellopoulos |
ORLANDO, Fla. — Two surgeons took opposing sides of the ongoing debate surrounding simultaneous corneal collagen crosslinking and photorefractive keratectomy versus crosslinking followed by PRK. John A. Kanellopoulos, MD, and Osama I. Ibrahim, MD, spoke during Refractive Subspecialty Day preceding the American Academy of Ophthalmology meeting.
Dr. Kanellopoulos said that crosslinking and PRK may be performed together with the support of proper preoperative corneal thickness and topography measurements.
"There is a synergistic effect when it's combined with cross-linking," Dr. Kanellopoulos said.
Patients treated with simultaneous crosslinking and PRK, and with PRK performed 6 months after crosslinking, yielded similar best corrected visual acuity results and keratometry measurements, Dr. Kanellopoulos said. Follow-up study is ongoing.
Dr. Kanellopoulos predicted that corneal cross-linking may someday be used in conjunction with LASIK by reducing the adverse biomechanical effects of LASIK flap creation, again with keen measurement. Whereas Dr. Ibrahim said that corneal crosslinking causes flattening of the cornea, which can diminish the refractive and biomechanical predictability of topography-guided PRK, and called for surgeons to perform crosslinking first and undertake PRK 6 months to 12 months later, only if corneal biomechanical stability is maintained.
- Disclosure: Drs. Kanellopoulos and Ibrahim have no relevant financial disclosures.