Results of corneal collagen cross-linking in patients with corneal ectasia after laser refractive surgery-A prospective study

Abstract

Purpose: To evaluate the safety and efficacy of epithelium-off (epi‑off) corneal cross-linking (CXL) in patients with post-LASIK corneal ectasia (PLE) SETTING: Private clinical practice DESIGN: Prospective clinical trial METHODS: 82 eyes of adult patients post-LASIK, ages 21-67, with a topography pattern consistent with corneal ectasia, corrected distance visual acuity (CDVA) worse than 20/20, and minimum corneal pachymetry > 400 µm underwent epi‑off CXL. Exclusion criteria were patients with corneas that were thinner than 400 μm or demonstrated central corneal scarring, history of herpetic eye disease, pregnancy or nursing. Follow up examinations of spherical equivalent, uncorrected distance visual acuity (UDVA), CDVA, steep keratometry (K_Steep) and minimum pachymetry occurred on different but highly overlapping subsets of the operated eyes yearly until 5 years post-CXL.

Results: Over the 5 years of follow up, spherical equivalent did not significantly change while UCVA and CDVA stabilized or improved to a non-significant degree. K_Steep and minimum pachymetry continued to be decreased to a statistically significant degree (p < 0.05 at 5 years).

Conclusions: CXL in PLE patients is safe and efficacious: it halts progression of PLE and may improve visual function. K_Steep and minimum pachymetry decrease post-CXL. Patients with PLE should be encouraged to stop progression of the disease by undergoing epi‑off CXL once progression is established.

Keywords: Crosslinking; Laser refractive surgery; OCT; Post-LASIK Ectasia.