Accelerated corneal crosslinking concurrent with laser in situ keratomileusis

• Published in: Journal of cataract and refractive surgery Vol. 38; no. 8; pp. 1424 - 1431
• Main Authors: Celik, H. Ugur, MD, Alagöz, Nese, MD, Yildirim, Yusuf, MD, Agca, Alper, MD, Marshall, John, MD, PhD, FRCOphth, FRCPath, Demirok, Ahmet, MD, Yilmaz, Omer Faruk, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2012; Elsevier
• Subjects: Adult; Astigmatism - drug therapy; Astigmatism - physiopathology; Astigmatism - surgery; Astigmatism - therapy; Biological and medical sciences; Cell Count; Collagen - metabolism; Combined Modality Therapy; Corneal Stroma - metabolism; Cross-Linking Reagents - therapeutic use; Dilatation, Pathologic - prevention & control; Endothelium, Corneal - pathology; Female; Humans; Keratomileusis, Laser In Situ - methods; Lasers, Excimer - therapeutic use; Male; Medical sciences; Myopia - drug therapy; Myopia - physiopathology; Myopia - surgery; Myopia - therapy; Ophthalmology; Photochemotherapy; Photosensitizing Agents - therapeutic use; Pilot Projects; Postoperative Complications - prevention & control; Prospective Studies; Refraction, Ocular - physiology; Riboflavin - therapeutic use; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Treatment Outcome; Ultraviolet Rays; Visual Acuity - physiology; Young Adult; Cornea; Keratomileusis; Treatment; Surgery; In situ; Laser; Ophthalmology
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2012.03.034

Purpose To assess accelerated corneal collagen crosslinking (CXL) applied concurrently with laser in situ keratomileusis (LASIK) in a small group of patients. Setting Beyoglu Eye Research and Training Hospital, Istanbul, Turkey. Design Prospective pilot interventional case series. Methods In May 2010, patients had LASIK with concurrent accelerated CXL in 1 eye and LASIK only in the fellow eye to treat myopia or myopic astigmatism. The follow-up was 12 months. The attempted correction (spherical equivalent) ranged from −5.00 to −8.50 diopters (D) in the LASIK–CXL group and from −3.00 to −7.25 D in the LASIK-only group. Main outcome measures were manifest refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, and the endothelial cell count. Results Eight eyes of 3 women and 1 man (age 22 to 39 years old) were enrolled. At the 12-month follow-up, the LASIK–CXL group had a UDVA and manifest refraction equal to or better than those in the LASIK-only group. No eye lost 1 or more lines of CDVA at the final visit. The endothelial cell loss in the LASIK–CXL eye was not greater than in the fellow eye. No side effects were associated with either procedure. Conclusions Laser in situ keratomileusis with accelerated CXL appears to be a promising modality for future applications to prevent corneal ectasia after LASIK treatment. The results in this pilot series suggest that evaluation of a larger study cohort is warranted. Financial Disclosure Drs. Yilmaz and Marshall are paid consultants to Avedro, Inc. No other author has a financial or proprietary interest in any material or method mentioned.