Topography-guided CK reshapes corneal profile in eyes with advanced keratoconus

Am J Ophthalmol. 2010;150(4):481-489.

Topography-guided conductive keratoplasty showed potential safety and efficacy in treating keratoconus, a study found.

"[We believe] that topography-guided conductive keratoplasty may be effective to reshape keratoconic eyes, as it provides marked improvements in corneal symmetry, contact lens tolerance, and visual performance," the study authors said. The procedure may delay or obviate the need for corneal transplantation, they said.

The interventional case series included 21 eyes of 21 patients with advanced keratoconus.

Investigators evaluated uncorrected visual acuity, best corrected visual acuity, corneal topography, manifest refraction, IOP, corneal endothelial cell counts, complications and visual outcomes at 1 day, 1 week, 1 month, 3 months, 6 months and 1 year after surgery.

Study results showed that corneal transplantation was avoided or delayed in 15 of 21 eyes (71.4%). Mean logMAR UCVA improved from 1.65 before surgery to 1.04 at 1 week and 1.12 at 1 month. The differences were statistically significant (both P < .001).

BCVA improved from 1.02 before surgery to 0.76 at 1 week and 0.76 at 1 month postoperatively. The gains were statistically significant (P = .026 and P = .003, respectively).

Manifest refraction diminished significantly, from –15.13 D before surgery to –9.97 D at 1 month postoperatively (P = .002).

Corneal topography, UCVA and BCVA devolved to preoperative levels. However, 12 of 21 eyes tolerated contact lenses and enabled patients to perform normal daily activities.

"More experiences with larger numbers of cases are required to address the precise indications for topography-guided conductive keratoplasty," the authors said.