Τίτλος:
Long-term Comparison of Combined t-PTK and CXL (Cretan Protocol) Versus CXL with Mechanical Epithelial Debridement for Keratoconus
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
PURPOSE: To compare the long-term outcomes of corneal cross-linking (CXL) for the treatment of keratoconus using two different techniques for epithelial removal: transepithelial phototherapeutic keratectomy (t-PTK) and mechanical epithelial debridement. METHODS: In this prospective, comparative, interventional case series, 26 patients (30 eyes) with progressive keratoconus underwent CXL treatment. Fifteen eyes (13 patients) underwent epithelial removal with t-PTK (Cretan protocol) and 15 eyes (13 patients) underwent mechanical epithelial debridement (Dresden protocol) during CXL. Visual, refractive, and keratometric outcomes were evaluated preoperatively and at 1, 2, 3, and 4 years postoperatively. RESULTS: No intraoperative or postoperative complications were observed in any of the patients. In the Cretan protocol group, mean uncorrected (UDVA) and corrected (CDVA) visual acuity improved from 0.99 ± 0.42 and 0.33 ± 0.28 logMAR preoperatively to 0.75 ± 0.32 (P = .018) and 0.21 ± 0.16 (P = .024) logMAR at 4 years postoperatively, respectively. In the Dresden protocol group, mean UDVA improved from 0.83 ± 0.47 logMAR preoperatively to 0.63 ± 0.40 logMAR (P = .033) at 4 years postoperatively, whereas mean CDVA did not demonstrate a statistically significant improvement postoperatively (P > .05). In the Cretan protocol group, mean corneal astigmatism improved from -6.19 ± 4.54 diopters (D) preoperatively to -4.68 ± 3.10 D (P = .041) at last follow-up, whereas in the Dresden protocol group there was no statistically significant difference postoperatively (P > .05). CONCLUSIONS: Epithelial removal with t-PTK during CXL (Cretan protocol) resulted in better visual, refractive, and keratometric outcomes compared with mechanical epithelial debridement over a long-term follow-up. Copyright © SLACK Incorporated.
Συγγραφείς:
Grentzelos, M.A.
Liakopoulos, D.A.
Siganos, C.S.
Tsilimbaris, M.K.
Pallikaris, I.G.
Kymionis, G.D.
Περιοδικό:
Journal of Refractive Surgery
Εκδότης:
SLACK Incorporated
Λέξεις-κλειδιά:
dexamethasone plus tobramycin; fluorometholone; collagen; cross linking reagent; photosensitizing agent, adult; Article; astigmatism; clinical article; comparative effectiveness; cornea surgery; cornea thickness; corneal cross linking; debridement; eye refraction; female; follow up; human; keratectomy; keratoconus; keratometry; male; postoperative period; preoperative period; priority journal; prospective study; transepithelial phototherapeutic keratectomy; treatment outcome; vision; visual acuity; comparative study; cornea epithelium; cornea stroma; debridement; excimer laser; keratoconus; metabolism; multimodality cancer therapy; photochemotherapy; photorefractive keratectomy; physiology; procedures; ultraviolet radiation; young adult, Adult; Collagen; Combined Modality Therapy; Corneal Stroma; Corneal Topography; Cross-Linking Reagents; Debridement; Epithelium, Corneal; Female; Follow-Up Studies; Humans; Keratoconus; Lasers, Excimer; Male; Photochemotherapy; Photorefractive Keratectomy; Photosensitizing Agents; Prospective Studies; Refraction, Ocular; Ultraviolet Rays; Visual Acuity; Young Adult
DOI:
10.3928/1081597X-20190917-01
