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One-Year Efficacy and Safety of Combined Photorefractive Keratectomy and Accelerated Corneal Collagen Cross-Linking after Intacs SK Intracorneal Ring Segment Implantation in Moderate Keratoconus

Authors
 Il Hwan Koh  ;  Kyoung Yul Seo  ;  Seong Bae Park  ;  Hun Yang  ;  InSik Kim  ;  Jin Sun Kim  ;  David G Hwang  ;  Sang Min Nam 
Citation
 BIOMED RESEARCH INTERNATIONAL, Vol.2019 : 7850216, 2019-07 
Journal Title
BIOMED RESEARCH INTERNATIONAL
ISSN
 2314-6133 
Issue Date
2019-07
MeSH
Adult ; Collagen / metabolism* ; Corneal Stroma* / diagnostic imaging ; Corneal Stroma* / metabolism ; Corneal Stroma* / physiopathology ; Corneal Stroma* / surgery ; Corneal Topography* ; Female ; Follow-Up Studies ; Humans ; Keratoconus* / diagnostic imaging ; Keratoconus* / metabolism ; Keratoconus* / physiopathology ; Keratoconus* / surgery ; Male ; Middle Aged ; Photorefractive Keratectomy* ; Retrospective Studies ; Safety* ; Visual Acuity*
Abstract
Purpose: To report one-year outcomes of a modified version of two-stage multimodal surgical protocol for moderate keratoconus which has been suggesting promising preliminary results.

Materials and methods: 30 eyes of 25 patients with moderate keratoconus who exhibited visual complaints and/or disease progression were included for this retrospective case study. Approximately 3 months after implantation of intracorneal ring segment (Intacs SK™), a combination of corneal wavefront-guided transepithelial photorefractive keratectomy (CWG-transPRK, Schwind Amaris® 1050, and Schwind Sirius) and accelerated collagen cross-linking (accCXL, Avedro KXL™) was performed. Patients were examined for uncorrected and corrected distance visual acuity (UDVA; CDVA), keratometric power (K), corneal thickness, and corneal higher-order aberrations (HOAs) preoperatively and at postoperative 1, 3, 6, and 12 months.

Results: The median UDVA and mean CDVA were enhanced from 6/38 to 6/12 and from 6/19 to 6/7.5, respectively, through 12 months after CWG-transPRK/accCXL. The 12-month CDVA of all patients was better than 6/12 Snellen, and no subject lost one or more lines of CDVA. The magnitudes of both myopia and corneal steepness were decreased in turn by Intacs SK implantation and also by CWG-transPRK/accCXL, but the reduction in HOA was largely the result of CWG-transPRK/accCXL. The magnitude of corneal thinning stabilized within 3 months after CWG-transPRK/accCXL.

Conclusion: This approach may allow patients with moderate keratoconus to obtain satisfactory vision without the need for contact lens wear. This surgery appeared to be effective and safe through 1 year of follow-up.
Files in This Item:
T201906765.pdf Download
DOI
10.1155/2019/7850216
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Seo, Kyoung Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188972
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