The purpose of this study is to evaluate safety and efficacy of corneal cross-linking and photorefractive keratectomy for refractive correction in patients with bilateral asymmetric topography.
Corneal cross-linking (CXL) by the photosensitizer, riboflavin (vitamin B2), and ultraviolet A (UVA) light increases corneal rigidity and has been described as an effective method for stabilizing the cornea in patients with progressive keratoconus. The photochemical reaction in this procedure causes the collagen to form additional covalent connections between its fibers, which stabilizes the stromal collagen fibers, improving the collagen's structure and the cornea rigidity. It is a relatively safe procedure with low rates of complications Photorefractive keratectomy (PRK) it is a traditional technique for refractive surgery. In cases of irregular corneas or re-operation normally the favorite ablation profile chosen is the guided surgery, topography guided or wavefront guided, showing better results. This technique is also relatively safe procedure with low rates of complications. One of the most unwanted complications of this surgery and also rare is corneal ectasia. Combining PRK and CXL is already done in patients with keratoconus and suspected keratoconus. This combined procedure uses the principle that CXL stiffen the cornea making it possible to reduce corneal thickness with PRK without weakening corneal strength. Literature show better results, in keratoconus, with simultaneous procedures. Guedj et al performed PRK in keratoconus suspects and within 5 years he did not found any corneal ectasia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
44
Corneal cross-linking with subsequent photorefractive keratotomy after 6 months was performed in one eye
Photorefractive keratotomy alone was performed in contra lateral eyes
Federal University of São Paulo
São Paulo, São Paulo, Brazil
Refractive results - spherical equivalent in diopters
Time frame: 30 months
Biomicroscopy findings with the slit lamp
Time frame: 30 months
Visual acuity in logMar
Time frame: 30 months
Aberrometric Results in root mean square
Only coma and spherical aberration
Time frame: 18 months
Topographic results in diopters
we will measure the increase in diopters with time
Time frame: 30 months
Pachymetric results in micra
Time frame: 30 months
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