Comparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking

Comparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking

Gitansha Shreyas Sachdev, Shreyas Ramamurthy, Ramamurthy Dandapani Refractive Services, The Eye Foundation, Coimbatore, India Purpose: To assess the safety, efficacy, and refractive predictability of half-fluence accelerated corneal collagen crosslinking (CXL) applied concurrently with photorefrac...

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Autores principales: Sachdev GS, Ramamurthy S, Dandapani R
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2018
Materias:
Photorefractive keratectomy (PRK)
Corneal collagen crosslinking (CXL)
LASIK Xtra
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/9f63bf72f6234332bfad7abc8839f1d4
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spelling oai:doaj.org-article:9f63bf72f6234332bfad7abc8839f1d42021-12-02T01:13:06ZComparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking1177-5483https://doaj.org/article/9f63bf72f6234332bfad7abc8839f1d42018-04-01T00:00:00Zhttps://www.dovepress.com/comparative-analysis-of-safety-and-efficacy-of-photorefractive-keratec-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Gitansha Shreyas Sachdev, Shreyas Ramamurthy, Ramamurthy Dandapani Refractive Services, The Eye Foundation, Coimbatore, India Purpose: To assess the safety, efficacy, and refractive predictability of half-fluence accelerated corneal collagen crosslinking (CXL) applied concurrently with photorefractive keratectomy (PRK), and compare the results to standard PRK.Setting: Refractive Services, The Eye Foundation, Coimbatore, India.Design: Interventional comparative case series.Methods: Patients seeking refractive correction for myopia or myopic astigmatism were included in the study. Photorefractive keratectomy with concurrent half-fluence crosslinking (PRK Xtra) was performed in eyes with borderline suspicious tomography (not amounting to forme fruste keratoconus) or low pachymetry between 450 and 474 µm with an otherwise unremarkable corneal tomography. Eyes with normal corneal tomography and thickness between 475 and 500 µm underwent standard PRK. The minimum follow-up period was 1 year. Results: In total, 109 eyes underwent PRK Xtra (Group A) and 118 eyes underwent PRK alone (Group B). The preoperative MRSE was −3.64 D and −3.38 D in Groups A and B, respectively (P=0.28). Group A had a significantly higher number of eyes with thinner corneas (P<0.01) and corneal tomographic abnormalities (P=0.02). At 1 year follow-up, 96.3% of eyes in group A as against 99.1% of eyes in group B achieved a best corrected distance visual acuity (CDVA) of 20/20 or better. No iatrogenic ectasia or hyperopic shift secondary to progressive flattening was noted in the PRK Xtra group. No significant difference in incidence of haze was noted.Conclusion: PRK Xtra showed comparable safety, efficacy, and stability to PRK in eyes with thinner pachymetry and tomographic abnormalities. Combining crosslinking with PRK in suspicious tomographies augurs for safe and predictable outcomes. Keywords: photorefractive keratectomy, PRK, corneal collagen crosslinking, CXL, PRK XtraSachdev GSRamamurthy SDandapani RDove Medical PressarticlePhotorefractive keratectomy (PRK)Corneal collagen crosslinking (CXL)LASIK XtraOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 783-790 (2018)
institution DOAJ
collection DOAJ
language EN
topic Photorefractive keratectomy (PRK)
Corneal collagen crosslinking (CXL)
LASIK Xtra
Ophthalmology
RE1-994
spellingShingle Photorefractive keratectomy (PRK)
Corneal collagen crosslinking (CXL)
LASIK Xtra
Ophthalmology
RE1-994
Sachdev GS
Ramamurthy S
Dandapani R
Comparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking
description Gitansha Shreyas Sachdev, Shreyas Ramamurthy, Ramamurthy Dandapani Refractive Services, The Eye Foundation, Coimbatore, India Purpose: To assess the safety, efficacy, and refractive predictability of half-fluence accelerated corneal collagen crosslinking (CXL) applied concurrently with photorefractive keratectomy (PRK), and compare the results to standard PRK.Setting: Refractive Services, The Eye Foundation, Coimbatore, India.Design: Interventional comparative case series.Methods: Patients seeking refractive correction for myopia or myopic astigmatism were included in the study. Photorefractive keratectomy with concurrent half-fluence crosslinking (PRK Xtra) was performed in eyes with borderline suspicious tomography (not amounting to forme fruste keratoconus) or low pachymetry between 450 and 474 µm with an otherwise unremarkable corneal tomography. Eyes with normal corneal tomography and thickness between 475 and 500 µm underwent standard PRK. The minimum follow-up period was 1 year. Results: In total, 109 eyes underwent PRK Xtra (Group A) and 118 eyes underwent PRK alone (Group B). The preoperative MRSE was −3.64 D and −3.38 D in Groups A and B, respectively (P=0.28). Group A had a significantly higher number of eyes with thinner corneas (P<0.01) and corneal tomographic abnormalities (P=0.02). At 1 year follow-up, 96.3% of eyes in group A as against 99.1% of eyes in group B achieved a best corrected distance visual acuity (CDVA) of 20/20 or better. No iatrogenic ectasia or hyperopic shift secondary to progressive flattening was noted in the PRK Xtra group. No significant difference in incidence of haze was noted.Conclusion: PRK Xtra showed comparable safety, efficacy, and stability to PRK in eyes with thinner pachymetry and tomographic abnormalities. Combining crosslinking with PRK in suspicious tomographies augurs for safe and predictable outcomes. Keywords: photorefractive keratectomy, PRK, corneal collagen crosslinking, CXL, PRK Xtra
format article
author Sachdev GS
Ramamurthy S
Dandapani R
author_facet Sachdev GS
Ramamurthy S
Dandapani R
author_sort Sachdev GS
title Comparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking
title_short Comparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking
title_full Comparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking
title_fullStr Comparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking
title_full_unstemmed Comparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking
title_sort comparative analysis of safety and efficacy of photorefractive keratectomy versus photorefractive keratectomy combined with crosslinking
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/9f63bf72f6234332bfad7abc8839f1d4
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AT ramamurthys comparativeanalysisofsafetyandefficacyofphotorefractivekeratectomyversusphotorefractivekeratectomycombinedwithcrosslinking
AT dandapanir comparativeanalysisofsafetyandefficacyofphotorefractivekeratectomyversusphotorefractivekeratectomycombinedwithcrosslinking
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