Novel Technique to Improve the Efficacy of Corneal Cross Linking in Cases of Post LASIK Ectasia

Abstract

Purpose

The aim of the present study was to validate the use of a novel technique that can improve the efficacy of corneal cross-linking (CXL) in cases with post LASIK ectasia.

Methods

This is a retrospective, comparative study that was conducted on patients who sought medical advice at Ain Shams University Hospitals and Maadi Eye Subspeciality Center, Cairo, Egypt. It included two groups of patients with post LASIK ectasia. Group 1 included patients who performed our proposed protocol (topo-guided PRK, followed by customized phototherapeutic keratectomy “PTK” to transmit the laser treatment to the corneal stroma, then CXL). For group 2, accelerated CXL was performed. Subjective refraction and relevant topographic/tomographic parameters (Sirius topographer) compared between the two groups. Recorded follow-ups included the 2 to 3-month follow-up visit and the last visit (mean ± SD of 17.2 months ± 10.2).

Results

Patients of group 1 (22 eyes of 22 patients) experienced significant improvements in most of the evaluated parameters at the 2- to 3-month follow-up visit and showed stability of the ectatic condition at the last follow-up visit, whereas patients of group 2 (10 eyes of 10 patients) showed stability of their ectatic condition at the 2- to 3-month follow-up visit, and one patient developed ectasia progression at the last follow-up visit.

Conclusion

The present study validates the use of our novel protocol in cases having post LASIK ectasia with proven efficacy, safety, and stability, providing regularization for the corneal surface while simultaneously avoiding the unnecessary loss of cross-linking effect within the LASIK flap that no longer shares in the corneal biomechanical strength.

Keywords:

• post LASIK ectasia
• novel technique post LASIK ectasia
• corneal cross-linking
• strengthening cross-linking efficacy
• post LASIK ectasia management

Data Sharing Statement

Available from the corresponding author upon reasonable request.

Ethics Approval and Informed Consents

This study was approved by the ethical committee of Ain Shams University (FMASU-R-190/2022). The institutional review board of Ain Shams University granted a waiver of informed consents, owing to the retrospective nature of the study. Patients data were kept anonymous with utmost confidentiality.

Acknowledgment

The authors would like to thank the statistician Mr Hesham Elkady for the performance of the statistical analysis of the manuscript.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

There is no funding to report.