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. 2022 May 18;15(5):721-727.
doi: 10.18240/ijo.2022.05.05. eCollection 2022.

Topography versus non-topography-guided photorefractive keratectomy with corneal cross-linking variations in keratoconus

Sana Niazi  1 , Jorge Alio Del Barrio  2   3 , Azad Sanginabadi  4 , Farideh Doroodgar  5 , Cyrus Alinia  6 , Alireza Baradaran-Rafii  1   7 , Feaizollah Niazi  1 , Hossein Mohammad-Rabei  1   5 , Mohammad Mehdi Sadoughi  1   5 , Jorge L Alio  2   3
Affiliations

Topography versus non-topography-guided photorefractive keratectomy with corneal cross-linking variations in keratoconus

Sana Niazi et al. Int J Ophthalmol. .

Abstract

Aim: To compare the visual results of non-topography-guided and topography-guided photorefractive keratectomy (PRK) applying sequential and simultaneous corneal cross-linking (CXL) treatment for keratoconus.

Methods: Interventional and comparative prospective study. Sixty-nine eyes (36 patients) suffering from keratoconus (stages 1 Amsler-Krumeich classification) were divided into four groups: sequential topography-guided photorefractive keratectomy with CXL, simultaneous topography-guided photorefractive keratectomy with CXL, simultaneous non-topography guided photorefractive keratectomy with CXL, and sequential non-topography guided photorefractive keratectomy with CXL. The main outcome measures were pre- and postoperative uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (CDVA), manifest refraction, contrast sensitivity, and keratometry.

Results: All analyzed visual, contrast sensitivity, and refractive parameters showed a significant improvement in the four groups (all P<0.05). A noticeable improvement was seen in keratometry in all the groups, and a remarkable difference was observed between topography-guided groups in comparison to non-topography-guided groups (P<0.05). Interestingly, the improvement in all parameters showed a degree of stability to the end of the follow-up.

Conclusion: The treatment priorities in all four groups are safety, efficacy, and predictability in the correction of the sphero-cylindrical errors in mild and moderate keratoconus. No significant differences among groups in the recorded objective outcomes were found.

Keywords: corneal collagen cross-linking; keratoconus; photorefractive keratectomy.

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Figures

Figure 1
Figure 1. Six years post-operative refraction
SE: Spherical equivalent; TG-PRK: Topography-guided photorefractive keratectomy.
Figure 2
Figure 2. Keratometry change preoperative and six years postoperative.
Figure 3
Figure 3. The postoperative contrast sensitivity in logarithmic scale under binocular photopic situation six years after surgery.
Figure 4
Figure 4. The postoperative contrast sensitivity in logarithmic scale under binocular mesopic situation six years after surgery.
See this image and copyright information in PMC

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