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Year : 2016  |  Volume : 17  |  Issue : 3  |  Page : 123-127

Simultaneous versus sequential photorefractive keratectomy and cross-linking for the management of early keratoconus

Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Correspondence Address:
Ashraf Bor'i
Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig 22486
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-9173.195268

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Purpose The aim of this study was to compare the safety and efficacy of simultaneous topography-guided photorefractive keratectomy (PRK) and corneal collagen cross-linking (CXL) with consecutive topography-guided PRK and CXL. Patients and methods A total of 34 eyes with early keratoconus were enrolled in this clinical study and assigned into two groups. Group A (n=17 eyes) underwent topography-guided PRK with CXL on the same day (the simultaneous group), and group B (n=17 eyes) underwent topography-guided PRK followed by CXL after 6 months (the sequential group). Changes in uncorrected and best-corrected visual acuity, spherical equivalent, keratometry (K), topography, and central corneal thickness were recorded. Follow-up was 12 months. Results The mean uncorrected visual acuity improved from 0.2±0.02 to 0.5±0.06 postoperatively in the simultaneous group at 12 months, whereas in the sequential group it improved from 0.25±0.03 to 0.5±0.08 (P=0.3). Best-corrected visual acuity improved from 0.4±0.25 to 0.8±0.3 postoperatively in the simultaneous group, whereas it improved from 0.5±0.12 to 0.7±0.2 in the sequential group (P=0.25). The mean spherical equivalent in the simultaneous group improved from –3.25±0.25 to –1.25±0.35 D with a mean reduction by 2.12±0.15 D, whereas in the sequential group it improved from –3.75±0.28 to –1.5±0.21 D with a reduction of 2.25±0.27 D (P=0.24). The mean reduction in K reading was 3.18±0.99 D in group A and 3.25±1.2 D in group B. Conclusion The same results have been obtained in both groups as regards the visual outcome in early cases with keratoconus.

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