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Comparison of Outcomes Between Combined Transepithelial Photorefractive Keratectomy With and Without Accelerated Corneal Collagen Cross-Linking: A 1-Year Study

 Lee Hun  ;  Yong Kang David Sung  ;  Ha Byoung Jin  ;  Choi Jin Young  ;  Kim Eung Kweon  ;  Seo Kyoung Yul  ;  Kim Tae-im 
 Cornea, Vol.36(10) : 1213-1220, 2017 
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Adult ; Collagen/metabolism* ; Combined Modality Therapy ; Corneal Stroma/metabolism* ; Corneal Topography ; Cross-Linking Reagents* ; Epithelium, Corneal ; Female ; Humans ; Keratoconus/drug therapy ; Keratoconus/metabolism ; Keratoconus/surgery ; Keratoconus/therapy* ; Lasers, Excimer/therapeutic use ; Male ; Photochemotherapy ; Photorefractive Keratectomy/methods* ; Photosensitizing Agents/therapeutic use* ; Refraction, Ocular/physiology ; Retrospective Studies ; Riboflavin/therapeutic use ; Treatment Outcome ; Ultraviolet Rays ; Visual Acuity/physiology ; Young Adult
PURPOSE: To investigate the effects of combined transepithelial photorefractive keratectomy (tPRK) and accelerated corneal collagen cross-linking (CXL) on visual acuity and refractive outcomes. METHODS: The medical records of 89 eyes (89 patients) undergoing combined tPRK and CXL (tPRK-CXL group) or tPRK alone (tPRK group) were retrospectively analyzed. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity, and manifest refraction spherical equivalent (MRSE) were evaluated preoperatively and 2 weeks, 1, 3, 6, and 12 months after surgery. RESULTS: At 2 weeks after surgery, the tPRK-CXL group had better UDVA than the tPRK group (0.97 ± 0.22 vs. 0.85 ± 0.22, P = 0.015). At 2 weeks and 1 month after surgery, the tPRK-CXL group had a significantly lower spherical error than the tPRK group (0.24 vs. 0.63 D, P = 0.017, for 2 weeks and 0.43 vs. 0.57 D, P = 0.019, for 1 month). At 12 months after surgery, the tPRK-CXL group had a lower spherical error and MRSE than the tPRK group (0.30 vs. 0.44 D, P < 0.001, for the spherical error and 0.17 vs. 0.31 D, P < 0.001, for the MRSE). Both groups had comparable predictability, efficacy, and safety indices at 12 months after surgery. CONCLUSIONS: Combined tPRK and accelerated CXL demonstrated comparable predictability, efficacy, and safety compared with tPRK alone. Combined tPRK and CXL provides better UDVA in the early postoperative period and better refractive outcomes at 12 months postoperatively in terms of spherical error and MRSE.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
김응권(Kim, Eung Kweon) ORCID logo https://orcid.org/0000-0002-1453-8042
김태임(Kim, Tae Im) ORCID logo https://orcid.org/0000-0001-6414-3842
서경률(Seo, Kyuong Yul) ORCID logo https://orcid.org/0000-0002-9855-1980
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