Corneal Collagen Crosslinking for Post-LASIK Ectasia: An Australian Study

Asia Pac J Ophthalmol (Phila). May-Jun 2017;6(3):228-232. doi: 10.22608/APO.2016197. Epub 2017 Mar 29.

Abstract

Purpose: Post laser-assisted in situ keratomileusis (LASIK) ectasia is a rare and unpredictable complication after LASIK. Corneal collagen crosslinking (CXL) has emerged as a promising technique to address this complication. Our study evaluates the long-term efficacy of CXL for post-LASIK ectasia in an Australian setting.

Design: Retrospective review of post-LASIK ectasia patients referred to and treated at 3 corneal refractive surgery institutions in Sydney, Australia.

Methods: Eleven patients (14 eyes; mean age, 39.7 ± 12.6 years) underwent epithelium-off CXL with follow-up ranging from 12-78 months. Best spectacle-corrected visual acuity (BSCVA), simulated keratometry, corneal topography indices, and higher-order aberrations (HOAs) [mean ± standard error of the mean (SEM)] were measured with a rotating Scheimpflug camera (Pentacam, Oculus). Comparisons between baseline measurements and postoperative outcomes were performed using paired t test analysis.

Results: At last follow-up, BSCVA improved significantly by 0.2 ± 0.06 logMAR (P = 0.01), and 12 of 14 eyes showed no keratometric deterioration. Of the corneal topography indices, index of height asymmetry showed a trend toward a significant improvement (P = 0.05). There was no progression of corneal HOAs. Central corneal thickness was not significantly altered (P = 0.6). No major postoperative complications were observed.

Conclusions: In the Australian setting, CXL has proven effective at stabilizing the progression of post-LASIK ectasia, inducing corneal regularity, and improving visual acuity.

Keywords: refractive surgery; LASIK; crosslinking; ectasia.

MeSH terms

  • Adult
  • Collagen / therapeutic use*
  • Cornea / pathology*
  • Cornea / surgery
  • Corneal Diseases / drug therapy*
  • Corneal Diseases / pathology
  • Corneal Topography
  • Cross-Linking Reagents / therapeutic use*
  • Dilatation, Pathologic / drug therapy
  • Dilatation, Pathologic / etiology
  • Dilatation, Pathologic / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Keratomileusis, Laser In Situ / adverse effects*
  • Male
  • Myopia / surgery*
  • Postoperative Complications*
  • Postoperative Period
  • Refraction, Ocular
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Cross-Linking Reagents
  • Collagen