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Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients

BACKGROUND: Keratoconus is a contraindication for photorefractive keratectomy (PRK). In the recent decade, some efforts have been made to perform PRK in patients with keratoconus whose corneas are stable naturally or by doing corneal collagen crosslinking. These studies have suggested residual centr...

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Autores principales: Khakshoor, Hamid, Razavi, Fatemeh, Eslampour, Alireza, Omdtabrizi, Arash
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399126/
https://www.ncbi.nlm.nih.gov/pubmed/25827548
http://dx.doi.org/10.4103/0301-4738.154400
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author Khakshoor, Hamid
Razavi, Fatemeh
Eslampour, Alireza
Omdtabrizi, Arash
author_facet Khakshoor, Hamid
Razavi, Fatemeh
Eslampour, Alireza
Omdtabrizi, Arash
author_sort Khakshoor, Hamid
collection PubMed
description BACKGROUND: Keratoconus is a contraindication for photorefractive keratectomy (PRK). In the recent decade, some efforts have been made to perform PRK in patients with keratoconus whose corneas are stable naturally or by doing corneal collagen crosslinking. These studies have suggested residual central corneal thickness (CCT) ≥450 μm. AIMS: The aim was to evaluate the long-term outcomes of PRK in patients with mild to moderate keratoconus in patients older than 40 with residual CCT ≥ 400 μm. SETTINGS AND DESIGN: This prospective study was conducted in our Cornea Research Center, Mashhad, Iran. MATERIALS AND METHODS: Patients over 40 years old, with a grade I/II keratoconus without progression in the last 2 years were recruited. Patients with a predicted postoperative CCT < 400 μm were excluded. PRK with tissue saving protocol was performed with Tecnolas 217 Z. Mitomycin-C was applied after ablation. The final endpoints were refraction parameters the last follow-up visit (mean: 35 months). Paired t-test and Chi-square were used for analysis. RESULTS: A total of 38 eyes of 21 patients were studied; 20 eyes (52.6%) with a grade I and 18 eyes (47.4%) with grade II keratoconus. The mean uncorrected visual acuity, best corrected visual acuity (BCVA), spherical equivalent, cylindrical power and keratometric readings were significantly improved at the final endpoint compared to preoperation measurements (P < 0.001). Two eyes (5%) lost two lines of BCVA at the final visit. No case of ectasia occurred during the follow-up course. CONCLUSIONS: PRK did not induce keratoconus progression in patients older than 40 with a grade I/II keratoconus. Residual CCT ≥ 450 μm seems to be sufficient to prevent the ectasia.
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spelling pubmed-43991262015-04-16 Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients Khakshoor, Hamid Razavi, Fatemeh Eslampour, Alireza Omdtabrizi, Arash Indian J Ophthalmol Original Article BACKGROUND: Keratoconus is a contraindication for photorefractive keratectomy (PRK). In the recent decade, some efforts have been made to perform PRK in patients with keratoconus whose corneas are stable naturally or by doing corneal collagen crosslinking. These studies have suggested residual central corneal thickness (CCT) ≥450 μm. AIMS: The aim was to evaluate the long-term outcomes of PRK in patients with mild to moderate keratoconus in patients older than 40 with residual CCT ≥ 400 μm. SETTINGS AND DESIGN: This prospective study was conducted in our Cornea Research Center, Mashhad, Iran. MATERIALS AND METHODS: Patients over 40 years old, with a grade I/II keratoconus without progression in the last 2 years were recruited. Patients with a predicted postoperative CCT < 400 μm were excluded. PRK with tissue saving protocol was performed with Tecnolas 217 Z. Mitomycin-C was applied after ablation. The final endpoints were refraction parameters the last follow-up visit (mean: 35 months). Paired t-test and Chi-square were used for analysis. RESULTS: A total of 38 eyes of 21 patients were studied; 20 eyes (52.6%) with a grade I and 18 eyes (47.4%) with grade II keratoconus. The mean uncorrected visual acuity, best corrected visual acuity (BCVA), spherical equivalent, cylindrical power and keratometric readings were significantly improved at the final endpoint compared to preoperation measurements (P < 0.001). Two eyes (5%) lost two lines of BCVA at the final visit. No case of ectasia occurred during the follow-up course. CONCLUSIONS: PRK did not induce keratoconus progression in patients older than 40 with a grade I/II keratoconus. Residual CCT ≥ 450 μm seems to be sufficient to prevent the ectasia. Medknow Publications & Media Pvt Ltd 2015-02 /pmc/articles/PMC4399126/ /pubmed/25827548 http://dx.doi.org/10.4103/0301-4738.154400 Text en Copyright: © Indian Journal of Ophthalmology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Khakshoor, Hamid
Razavi, Fatemeh
Eslampour, Alireza
Omdtabrizi, Arash
Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients
title Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients
title_full Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients
title_fullStr Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients
title_full_unstemmed Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients
title_short Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40-year-old patients
title_sort photorefractive keratectomy in mild to moderate keratoconus: outcomes in over 40-year-old patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399126/
https://www.ncbi.nlm.nih.gov/pubmed/25827548
http://dx.doi.org/10.4103/0301-4738.154400
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