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ORIGINAL ARTICLE
Year : 2021  |  Volume : 22  |  Issue : 1  |  Page : 10-18

Wavefront-guided photorefractive keratectomy combined with prophylactic corneal collagen cross-linking in myopic patients with borderline corneal tomography


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

Correspondence Address:
MD Mortada A Abozaid
Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag 82524
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/DJO.DJO_41_20

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Purpose The aim of this study was to assess the safety, efficacy, and predictability of wavefront-guided photorefractive keratectomy with simultaneous half-fluence accelerated collagen cross-linking (WFG-PRK Xtra) in myopic eyes with suspicious or borderline corneal tomography. Patients and methods A total of 67 eyes of 40 patients with myopia or myopic astigmatism (sphere <−5.0 D and cylinder <−3.0 D), with abnormal corneal tomography not amounting to forme fruste keratoconus, were included in this retrospective comparative study. Eyes were divided into two groups: 37 eyes (group 1) had WFG-PRK Xtra, whereas 30 eyes (group 2) had conventional PRK with accelerated collagen cross-linking (PRK Xtra). All cases completed at least 1 year of follow-up. Results In group 1 (WFG-PRK Xtra), the mean uncorrected visual acuity improved from 0.96±0.3 to 0.05±0.06 (logMAR) and the mean spherical equivalent decreased from −5.22±2.03 to −0.14±0.32 D. The spherical aberration showed statistically significant increase from 0.05 μm preoperatively to 0.09 μm postoperatively. Three patients developed significant haze and two patients showed overcorrection. However, in group 2 (conventional PRK Xtra), the mean uncorrected visual acuity improved from 0.97±0.35 to 0.04±0.05 (logMAR) and the mean spherical equivalent decreased from −4.98±1.88 to −0.15±0.29 D, whereas the spherical aberration increased from 0.04 to 0.05 μm. Two patients developed significant haze and one patient showed regression. No cases of postoperative ectasia were detected in either group. Conclusion The results of this study suggest that both WFG and conventional PRK with simultaneous half-fluence corneal collagen cross-linking were safe, effective, and predictable in refractive candidates with abnormal or borderline corneal tomography.


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