TY - JOUR
T1 - Epithelial photorefractive keratectomy and corneal cross-linking for keratoconus
T2 - The TeL-AviV protocol
AU - Kaiserman, Igor
AU - Mimouni, Michael
AU - Rabina, Gilad
N1 - Publisher Copyright:
© 2019 Slack Incorporated. All rights reserved.
PY - 2019
Y1 - 2019
N2 - PURPOSE: To present the Tel-Aviv Protocol for patients with progressive keratoconus, which consists of epithelial photorefractive keratectomy (ePRK), and corneal cross-linking (CXL). METHODS: This was a retrospective case series of 20 consecutive patients diagnosed as having progressive keratoconus at Care-Vision Laser Centers, Tel Aviv, Israel. The Tel-Aviv Protocol included laser epithelial ablation using the EX500 excimer laser (Alcon Laboratories, Inc., Fort Worth, TX) with 50% of the manifest refractive astigmatism (on the same axis) while the spherical ablation is added so as not to exceed a total of 50-µm ablation of the epithelium and anterior stroma. Afterward, all patients underwent CXL. Data collected included thinnest corneal thickness (TCT), subjective astigmatism, mean keratometric power, maximum keratometric power (Kmax), uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA). RESULTS: A total of 20 eyes of 20 patients with a mean age of 28.0 ± 6.5 years (range: 13 to 40 years) and a mean follow-up of 823 ± 337 days (range: 266 to 1,749 days) were included. There was a significant improvement in both UDVA (from 0.95 ± 0.73 to 0.22 ± 0.15 logMAR, P < .001) and CDVA (from 0.24 ± 0.13 to 0.13 ± 0.12 logMAR, P < .001) at the end of the follow-up period. There was a significant improvement in mean keratometry (from 46.86 ± 2.48 to 45.00 ± 2.27 diopters [D], P < .001), Kmax (from 48.18 ± 2.74 to 45.97 ± 2.55 D, P < .001), and Kmin (from 45.54 ± 2.35 to 44.03 ± 2.12 D, P < .001). TCT was significantly lower following the procedure (from 450.90 ± 35.99 to 404.90 ± 43.96 µm, P < .001). No complications and no progression in keratoconus severity were noticed during the follow-up period. CONCLUSIONS: The Tel-Aviv Protocol for patients with progressive keratoconus provides good improvement in visual acuity and astigmatism while halting the progression of keratoconus.
AB - PURPOSE: To present the Tel-Aviv Protocol for patients with progressive keratoconus, which consists of epithelial photorefractive keratectomy (ePRK), and corneal cross-linking (CXL). METHODS: This was a retrospective case series of 20 consecutive patients diagnosed as having progressive keratoconus at Care-Vision Laser Centers, Tel Aviv, Israel. The Tel-Aviv Protocol included laser epithelial ablation using the EX500 excimer laser (Alcon Laboratories, Inc., Fort Worth, TX) with 50% of the manifest refractive astigmatism (on the same axis) while the spherical ablation is added so as not to exceed a total of 50-µm ablation of the epithelium and anterior stroma. Afterward, all patients underwent CXL. Data collected included thinnest corneal thickness (TCT), subjective astigmatism, mean keratometric power, maximum keratometric power (Kmax), uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA). RESULTS: A total of 20 eyes of 20 patients with a mean age of 28.0 ± 6.5 years (range: 13 to 40 years) and a mean follow-up of 823 ± 337 days (range: 266 to 1,749 days) were included. There was a significant improvement in both UDVA (from 0.95 ± 0.73 to 0.22 ± 0.15 logMAR, P < .001) and CDVA (from 0.24 ± 0.13 to 0.13 ± 0.12 logMAR, P < .001) at the end of the follow-up period. There was a significant improvement in mean keratometry (from 46.86 ± 2.48 to 45.00 ± 2.27 diopters [D], P < .001), Kmax (from 48.18 ± 2.74 to 45.97 ± 2.55 D, P < .001), and Kmin (from 45.54 ± 2.35 to 44.03 ± 2.12 D, P < .001). TCT was significantly lower following the procedure (from 450.90 ± 35.99 to 404.90 ± 43.96 µm, P < .001). No complications and no progression in keratoconus severity were noticed during the follow-up period. CONCLUSIONS: The Tel-Aviv Protocol for patients with progressive keratoconus provides good improvement in visual acuity and astigmatism while halting the progression of keratoconus.
UR - http://www.scopus.com/inward/record.url?scp=85067792637&partnerID=8YFLogxK
U2 - 10.3928/1081597X-20190514-01
DO - 10.3928/1081597X-20190514-01
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C2 - 31185103
AN - SCOPUS:85067792637
SN - 1081-597X
VL - 35
SP - 377
EP - 382
JO - Journal of Refractive Surgery
JF - Journal of Refractive Surgery
IS - 6
ER -