Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients

Khakshoor, H. and Razavi, F. and Eslampour, A. and Omdtabrizi, A. (2015) Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients. Indian Journal of Ophthalmology, 63 (2). pp. 157-161.

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Abstract

Background: Keratoconus is a contraindication for photorefractive keratectomy (PRK). In the recent decade, some efforts have been made to perform PRK in patients with keratoconus whose corneas are stable naturally or by doing corneal collagen crosslinking. These studies have suggested residual central corneal thickness (CCT) ≥450 μm. Aims: The aim was to evaluate the long-term outcomes of PRK in patients with mild to moderate keratoconus in patients older than 40 with residual CCT ≥ 400 μm. Settings and Design: This prospective study was conducted in our Cornea Research Center, Mashhad, Iran. Materials and Methods: Patients over 40 years old, with a grade I/II keratoconus without progression in the last 2 years were recruited. Patients with a predicted postoperative CCT < 400 μm were excluded. PRK with tissue saving protocol was performed with Tecnolas 217 Z. Mitomycin-C was applied after ablation. The final endpoints were refraction parameters the last follow-up visit (mean: 35 months). Paired t-test and Chi-square were used for analysis. Results: A total of 38 eyes of 21 patients were studied; 20 eyes (52.6) with a grade I and 18 eyes (47.4) with grade II keratoconus. The mean uncorrected visual acuity, best corrected visual acuity (BCVA), spherical equivalent, cylindrical power and keratometric readings were significantly improved at the final endpoint compared to preoperation measurements (P < 0.001). Two eyes (5) lost two lines of BCVA at the final visit. No case of ectasia occurred during the follow-up course. Conclusions: PRK did not induce keratoconus progression in patients older than 40 with a grade I/II keratoconus. Residual CCT ≥ 450 μm seems to be sufficient to prevent the ectasia.

Item Type: Article
Additional Information: Cited By :6 Export Date: 16 February 2020 CODEN: IJOMB Correspondence Address: Omdtabrizi, A.; Department of Ophthalmology, Eye Research Center, Khatam-Al-Anbia Eye HospitalIran
Uncontrolled Keywords: Ectasia keratoconus photorefractive keratectomy adult cornea excimer laser eye refraction female follow up human keratometry male middle aged pathology physiology procedures prospective study therapeutic use time factor treatment outcome visual acuity Corneal Topography Follow-Up Studies Humans Lasers, Excimer Prospective Studies Refraction, Ocular Time Factors
Subjects: WW Ophthalmology
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib5 lib5
Date Deposited: 13 May 2020 07:45
Last Modified: 13 May 2020 07:45
URI: http://eprints.mums.ac.ir/id/eprint/18920

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