Omar Yousif Mohamed, Elkitkat Rania Serag, Abdelsadek Alaarag Noha
Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Maadi Eye Subspecialty Center, Cairo, Egypt.
Clin Ophthalmol. 2023 Apr 11;17:1109-1120. doi: 10.2147/OPTH.S409256. eCollection 2023.
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.
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).
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.
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.
本研究旨在验证一种新技术的应用，该技术可提高准分子激光原位角膜磨镶术（LASIK）后角膜扩张病例中角膜交联（CXL）的疗效。
这是一项回顾性比较研究，对在埃及开罗艾因夏姆斯大学医院和马阿迪眼科专科医院寻求医疗建议的患者进行。研究包括两组LASIK后角膜扩张患者。第1组包括实施我们提出方案的患者（地形图引导的准分子激光角膜切削术“PRK”，随后进行定制的光治疗性角膜切削术“PTK”以将激光治疗传递至角膜基质，然后进行CXL）。第2组进行加速CXL。比较两组之间的主观验光和相关地形图/断层扫描参数（Sirius地形图仪）。记录的随访包括2至3个月的随访以及最后一次随访（平均±标准差为17.2个月±10.2）。
第1组患者（22例患者的22只眼）在2至3个月随访时大多数评估参数有显著改善，并且在最后一次随访时扩张情况稳定，而第2组患者（10例患者的10只眼）在2至3个月随访时扩张情况稳定，且有1例患者在最后一次随访时出现角膜扩张进展。
本研究验证了我们的新方案在LASIK后角膜扩张病例中的应用，其具有已证实的疗效、安全性和稳定性，可使角膜表面规则化，同时避免LASIK瓣内交联效应的不必要损失，而该瓣不再参与角膜生物力学强度。
