Crosslinking for post refractive surgery ectasia: application and clinical outcomes.

Area of Science:

• Ophthalmology
• Corneal Surgery
• Laser Vision Correction Complications

Background:

• Post-laser vision correction ectasia (PLE) is a severe complication following laser vision correction surgery.
• PLE is characterized by progressive corneal thinning, increased myopia, and irregular astigmatism.

Purpose of the Study:

• To evaluate the long-term effectiveness of pachymetry-guided Epithelium-Off accelerated crosslinking (ACXL) in managing PLE.
• To assess the impact of ACXL on corneal stability and visual outcomes in PLE patients.

Main Methods:

• A before-after comparative case series involving 13 eyes of 10 patients diagnosed with PLE.
• Standardized over-the-flap crosslinking (S-ACXL) with epithelial removal (Epi-Off) was performed.
• UV-A irradiation parameters were customized using the M nomogram based on baseline corneal pachymetry.

Main Results:

• Corneal thickness remained stable throughout the follow-up period, indicating PLE stabilization.
• A statistically significant reduction in posterior elevation (PE) was observed (P < 0.005).
• Corrected distance visual acuity significantly improved by 2 ± 0.57 Snellen lines (P = 0.05), with decreased high-order aberrations.

Conclusions:

• Pachymetry-guided ACXL is effective in stabilizing PLE and preventing disease progression.
• The procedure leads to significant improvements in visual acuity and functional outcomes.
• No adverse events were reported, highlighting the safety of this treatment approach.