Topography-guided PRK with cross-linking may treat post-LASIK ectasia

SAN DIEGO — Study of post-LASIK eyes with ectasia that were treated with topography-guided PRK and cross-linking yielded satisfactory safety and efficacy results, according to a speaker here.

“Ectasia is a very challenging problem for us to manage because patients are usually very symptomatic, very disappointed, and the astigmatism is often extreme,” Simon P. Holland, MB, FRCSC, said at World Cornea Congress.

Simon P. Holland

The retrospective study spanned a period of 5 years and included 56 eyes of patients with ectasia who were contact lens intolerant.

Holland and colleagues used the WaveLight Allegretto Wave Eye-Q Laser (Alcon) to perform transepithelial topography-guided PRK using a TCAT program with simultaneous cross-linking.

Uncorrected visual acuity, best corrected visual acuity, manifest refraction, symptom score, topography and keratometry data were collected preoperatively and at 1 month, 2 months, 3 months, 6 months and 12 months. Of 35 eyes with sufficient data for analysis, uncorrected visual acuity was 20/40 or better in 19 eyes; best corrected visual acuity improved in 23 eyes; 10 eyes gained two or more lines and two eyes lost two lines.

Mean reduction in astigmatism was 2.47 D.

Complications included delayed epithelialization and visually symptomatic haze, Holland said.

Concerns with topography-guided PRK are potential for corneal thinning, hyperopia less than expected and delayed epithelialization in cases of endothelial damage, Holland said. — by Nhu Te

Disclosure: Holland reports no relevant financial interests.