ThreeYears Results After Femtosecond LaserAssisted Circular Keratotomy as a Treatment for Keratoconu

Three-Years Results After Femtosecond Laser-Assisted Circular Keratotomy as a Treatment for Keratoconus Stages I-II: Comparison with Iontophoresis-Assisted CXL

2018

Author: Detlev R. Breyer, MD

Contributors: Hakan Kaymak, Karsten Klabe, Philipp Hagen, Timon Ax, Florian Kretz, Gerd Auffarth

Purpose:

The aim of this analysis is to address the question, whether Femtosecondlaser-assisted Circular keratotomy (FSCKT) is as effective in halting progression of keratoconus of stage I and II as (Iontophoresis-Assisted) Corneal Collagen Cross-Linking ((I)CXL).

Methods:

Circular keratotomy (CKT) represents an effective treatment of the progression of keratoconus. Recently, we refined CKT by replacing the trephine cut technique by a Femtosecondlaser-induced intracorneal cut (FSCKT), rendering sutures unnecessary. In this study, 10 eyes were treated with FSCKT. Follow up measurements were performed at 3, 6, 12, 24 and 36 months. Manifest refraction and corrected monocular visual acuity at far (CDVA) were measured with a phoropter and EDTRS charts. Corneal radii and pachymetry as well as Belin/Ambrósio Enhanced Ectasia data was assessed via Scheimpflug tomography (Pentacam, oculus). We compared the results with eyes that underwent CXL or the novel ICXL.

Results:

In 9 of 10 eyes, no signs of a progressing keratoconus were found. Minimum corneal radii (all within a +-0.3mm range of the preoperative value), corneal thickness at the thinnest point (all within a +-15 µm range of the preop value) as well as the Belin/Ambrósio enhanced ectasia total deviation index (BAD-D) remained stable within the 3-year follow up. CDVA was <0.00 logmar="" 3="" years="" after="" surgery="" and="" improved="" compared="" to="" its="" preoperative="" value.="" mean="" values="" were="" comparable="" with="" those="" in="" the="" cxl-group="" and="" the="" (i)cxl-group.="" however,="" 1="" eye="" (10%)="" initially="" treated="" with="" fsckt="" displayed="" progressing="" keratoconus="" and="" was="" retreated="" with="" cxl.="" logmar="" 3="" years="" after="" surgery="" and="" improved="" compared="" to="" its="" preoperative="" value.="" mean="" values="" were="" comparable="" with="" those="" in="" the="" cxl-group="" and="" the="" (i)cxl-group.="" however,="" 1="" eye="" (10%)="" initially="" treated="" with="" fsckt="" displayed="" progressing="" keratoconus="" and="" was="" retreated="" with="">

Conclusions:

So far, our 3-year results indicate that FSCKT is as effective in stopping the progression of keratoconus of stage I and II as CXL.