Tel-Aviv Protocol for Postrefractive Surgery Corneal Ectasia: A Case Series

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Postrefractive surgery corneal ectasia is a rare but serious complication following refractive procedures.
• This condition can lead to progressive vision loss and irregular astigmatism.
• Current treatment options for advanced ectasia may include corneal transplantation.

Purpose of the Study:

• To evaluate the safety and efficacy of the Tel-Aviv Protocol for treating postrefractive surgery corneal ectasia.
• To assess the visual and refractive outcomes of this combined surgical approach.

Main Methods:

• The study involved 8 eyes from 7 patients diagnosed with postrefractive surgery ectasia.
• Treatment consisted of transepithelial photorefractive keratectomy (PRK) using the EX500 excimer laser, followed by corneal cross-linking.
• Epithelial PRK involved a 50-μm ablation of the epithelium and anterior stroma to correct astigmatism.

Main Results:

• Significant reductions in mean and maximal keratometry were observed (P = 0.03).
• Astigmatism was significantly reduced (P = 0.02), and uncorrected visual acuity improved markedly (P = 0.01).
• Best-corrected visual acuity showed improvement (1-tail P = 0.04), with visual stability maintained up to 25 months.

Conclusions:

• The Tel-Aviv Protocol is a safe and effective treatment for postrefractive surgery corneal ectasia.
• This procedure demonstrates potential to halt ectasia progression and improve visual function.
• It offers a viable alternative to keratoplasty for eligible patients.