High-resolution wavefront-guided surface ablation with corneal cross-linking in ectatic corneas: a pilot study

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Corneal ectasia, including keratoconus and post-LASIK ectasia, poses a significant challenge in refractive surgery.
• Traditional treatments for ectasia often focus on halting progression rather than improving visual function.

Purpose of the Study:

• To evaluate the efficacy and outcomes of high-resolution wavefront-guided photorefractive keratectomy (HRWG PRK) combined with simultaneous corneal cross-linking (CXL).
• To assess the refractive, visual acuity, and aberrometric results of this combined procedure in patients with corneal ectasia.

Main Methods:

• A prospective study involving 16 eyes of 11 patients diagnosed with keratoconus or post-LASIK ectasia.
• Patients underwent HRWG PRK with simultaneous CXL, with a minimum residual stromal bed thickness of 350 μm.
• Visual acuity (UDVA, CDVA), manifest refraction, keratometry, and aberrometry were evaluated at 12 months postoperatively.

Main Results:

• Significant improvements in visual acuity and refraction were observed across all treated eyes.
• At 12 months, 87.5% of eyes were within ±1.0 D of attempted correction, and 81.25% achieved an uncorrected distance visual acuity (UDVA) of 20/32 or better.
• A reduction in higher-order aberrations was noted, though not statistically significant. Some eyes experienced gains in corrected distance visual acuity (CDVA).

Conclusions:

• HRWG PRK with simultaneous CXL is a promising treatment for corneal ectasia in eyes with adequate stromal thickness.
• The procedure offers a valuable surgical option for improving vision and refractive predictability in ectatic corneas.
• Further research is warranted to fully elucidate the long-term benefits and potential limitations.