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Cross-linking followed by customized surface ablation may effectively treat keratoconus

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BARCELONA — Cross-linking followed by customized surface ablation is an effective treatment of keratoconus, especially in patients who cannot tolerate contact lenses, a presenter here said.

Tassos Georgiou, MD, presented results of a prospective, non-comparative study of 94 eyes with keratoconus at the European Society of Cataract and Refractive Surgeons meeting. The study period was from September 2006 to December 2008. All patients received UVA irradiation after topical 0.1% riboflavin drops application (one drop every 3 minutes for 30 minutes) over a partially spotted de-epithelialized cornea. After a minimum 4-week wait after cross-linking, surgeons performed topography-guided ablation with the Allegretto 400 Hz excimer laser.

Mean uncorrected visual acuity improved from 0.20 to 0.79, Dr. Georgiou said. Best corrected visual acuity improved in 34% of the eyes greater than 50% and in 31% of the eyes between 20% and 50%. Mean spherical equivalent was reduced by -2.90 D, and the mean maximum ablation depth was 85 µm.

Dr. Georgiou said the results are promising; however, longer follow-up is required.