ArticleVisual and keratometric outcomes of keratoconus patients after sequential corneal crosslinking and topography-guided surface ablation: Early United States experienceNattis, Alanna DO*; Donnenfeld, Eric D. MD; Rosenberg, Eric DO, MSE; Perry, Henry D. MD Author Information From Lindenhurst Eye Physicians and Surgeons (Nattis), Babylon, Ophthalmic Consultants of Long Island (Donnenfeld), Garden City, the Department of Ophthalmology (Rosenberg), New York Medical College, Valhalla, Nassau University Medical Center (Perry), and Ophthalmic Consultants of Long Island (Perry), Rockville Centre, New York, USA *Corresponding author: Alanna Nattis, DO, Lindenhurst Eye Physicians and Surgeons PC, 500 West Main Street, Babylon, New York 11702, USA. E-mail: [email protected] Submitted January 4, 2018; revised May 1, 2018; accepted May 25, 2018.Figure: No Caption available.First author: Alanna Nattis, DO Lindenhurst Eye Physicians and Surgeons, Babylon, New York, USA Presented in part at the ASCRS Symposium on Cataract, IOL and Refractive Surgery, Los Angeles, California, USA, May 2017. Journal of Cataract & Refractive Surgery 44(8):p 1003-1011, August 2018. | DOI: 10.1016/j.jcrs.2018.05.020 Buy Metrics Abstract Purpose To evaluate a sequential treatment algorithm for visual and keratometric improvement in keratoconus patients after corneal crosslinking (CXL) followed by topography-guided photorefractive keratectomy (PRK). Setting Ophthalmic Consultants of Long Island, Garden City, New York, USA. Design Retrospective case series. Methods This study reviewed patients with keratoconus who had CXL followed by custom topography-guided PRK between April 2016 and December 2016. The following data were collected at baseline, the time of CXL, and 3 months and 6 months after PRK: uncorrected (UDVA) and corrected (CDVA) distance visual acuities, keratometric astigmatism, spherical equivalent, maximum and mean keratometry readings, and corneal thickness at the cone apex. Demographic data, age at time of CXL and PRK, and time elapsed between CXL and PRK were analyzed for significance and a correlation with visual and astigmatic outcomes. Results The study comprised 56 patients (62 eyes), 34 who had both topographic and refractive treatment and 28 patients who had treatment of topographic irregularities only. The mean age was 38.08 years ± 13.07 (SD) at CXL and 40.33 ± 13.44 years at topography-guided PRK. Six months after PRK, there was a significant improvement in UDVA and CDVA in the refractive group (20/60 and 20/30, respectively) versus the nonrefractive group (20/100 and 20/40, respectively). Ninety-three percent of eyes that had refractive treatment had 20/40 or better CDVA. There were no significant adverse events in any case. Conclusions The data support the use of refractive treatment in addition to topographic treatment for visual improvement in patients with keratoconus having CXL and PRK. © 2018 by Lippincott Williams & Wilkins, Inc.
