Abstract
Purpose: To analyze the results of three-year outcomes of combined epithelium-on Cross-linking with femtosecond laser ICRS (Cross-Linking PLUS) for keratoconus management.
Design: A retrospective multicenter clinical study.
Methods: 43 eyes of 38 patients were subjected to preoperative and postoperative UCVA, BCVA, refraction, Pentacam pachymetry and keratometry examinations at 3, 6, 12, 24 and 36 months follow up period.
Results: The preoperative and postoperative mean UCVA was 1.30 ± 0.48 (logMAR±SD) and 0.82 ± 0.22 respectively. The preoperative and postoperative mean BCVA was 0.90 ± 0.40 and 0.60 ± 0.30 respectively. The preoperative and postoperative mean K average was 50.63 ± 0.87 (D±SD) and 45.56 ± 0.98 respectively. The preoperative and postoperative mean pachymetry was 471 ± 92.36 (μm±SD) and 423 ± 39.58 respectively. The preoperative and postoperative mean astigmatism was 7.55 ± 1.75 and 3.39 ± 1.26 respectively. One eye showed ICRS edge exposure while 6 eyes showed progression of keratoconus.
Conclusion: CXL PLUS was proved to be a successful procedure to halt progression (mainly by CXL) and to correct the refractive status of the keratoconic eye (mainly by ICRS). CXL PLUS performed a synergistic action correcting and maintaining the correction of both myopic and astigmatic components of keratoconus.