AI Article Synopsis

  • The study aimed to introduce and evaluate a new tissue-saving technique combining topography-guided PRK and cross-linking for keratoconus treatment in Egypt.
  • It involved retrospective analysis of 123 eyes from 93 patients, assessing preoperative and postoperative data, which revealed significant improvements post-treatment without major differences among different ectasia subgroups.
  • The results demonstrate that this revised technique is effective, safe, and maintains stability while preserving more corneal tissue.

Article Abstract

Purpose: The aim of this study was to introduce a revised tissue-saving technique for combined topography-guided photorefractive keratectomy (PRK) and cross-linking for keratoconus (KC) treatment and to evaluate its efficacy, safety, and stability.

Methods: This retrospective, noncontrolled study was performed at Maadi Eye Subspecialty Center and Eye Care Center, Cairo, Egypt. The technique was performed on virgin keratoconic corneas with 3 different morphological patterns of ectasia. It involves performing topography-guided PRK before epithelial removal, followed by customized phototherapeutic keratectomy (PTK) that is tailored to each cornea after studying the treatment profile on the laser treatment screen. The electronic medical records were explored for preoperative and postoperative data, including subjective refraction and topographic data (using Sirius topographer).

Results: The study was conducted on 123 eyes of 93 patients with a mean age of 27.98 years ±6.06. The follow-up ranged from 6 to 36 months (mean ± SD of 16.2 months ±10.4). The results showed statistically nonsignificant differences among the 3 ectasia subgroups in treatment spherical equivalent, treatment maximum depth, thickness of removed epithelium, and thinnest residual stromal bed. There were statistically significant differences in almost all values between the preoperative and postoperative data, with significant postoperative patients' improvement ( P value <0.001). The subgroups' results were almost the same as the whole cohort's results. The safety and efficacy indices of the performed procedure showed remarkably high values (1.48 ± 0.21 and 0.87 ± 0.40, respectively).

Conclusions: This revised protocol for KC management maximally preserves stromal tissue with proven efficacy, safety, and stability.

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Source
http://dx.doi.org/10.1097/ICO.0000000000003225DOI Listing

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