CK, cross-linking yield improvement in corrected distance visual acuity in patients with ectasia

SEATTLE — Conductive keratoplasty in combination with epi-on cross-linking showed improvement in corrected distance visual acuity in patients with ectasia, according to a poster presented here.

“It’s a really exciting study, and it’s an ongoing study. Our numbers are growing rapidly, and we’re having really great results in terms of 1 day vs. same day,” Olivia Dryjski, MD, told Ocular Surgery News in an interview at the Association for Research in Vision and Ophthalmology meeting.

The nonrandomized, prospective, noncomparative case series included 209 eyes of 149 patients with ectasia. All eyes had corneas that were 325 µm or thicker, rigid contact lens use within 4 weeks of CK and adequate corrected distance visual acuity.

Seventeen percent of eyes were treated for post-LASIK ectasia, and 81% of eyes were treated for keratoconus or pellucid marginal degeneration.

Researchers performed CK using intraoperative keratometry and serial Oculus Pentacam tomography measurements, and cross-linking was performed using a novel proprietary riboflavin loading system either on the same day as CK or 1 day after CK was performed.

Patients were followed up at 1 month, 2 months to 4.5 months, 4.5 months to 10 months, and 10 months to 15 months.

At the 10 month to 15 month follow-up, mean improvement in corrected distance visual acuity was 0.106 logMAR (P = .001). Mean improvement was 0.08 logMAR (P = .03) in eyes that received cross-linking on the same day as CK and 0.16 logMAR (P = .01) in eyes that received cross-linking 1 day after CK.

In eyes that had baseline corrected distance visual acuity of 20/40 or worse, mean improvement was 0.17 logMAR in eyes that received cross-linking on the same day as CK (P = .02) and 0.41 logMAR in eyes that received cross-linking 1 day after CK (P < .001).

“These results are more pronounced at 10 to 15 months, as there was markedly more regression in patients with same-day CK plus CXL by 10 to 15 months postoperatively. As expected, greater results are visible in patients with a preoperative CDVA of 20/40 or worse,” the study authors wrote. – by Nhu Te

Reference:

Dryjski O, et al. Same day vs. sequential CK + CXL in the treatment of ectasia. Presented at: Association for Research in Vision and Ophthalmology meeting; May 1-5, 2016; Seattle.

Disclosure: Dryjski reports no relevant financial disclosures.