Treatment of Keratoconus with WaveLight Contoura and Corneal Cross-Linking Combined

PURPOSE: To investigate the outcomes of the treatment of keratoconus/corneal ectasia utilizing topographic-guided ablation (WaveLight Contoura) followed by corneal cross-linking. METHODS: Thirty-six eyes of 21 patients were treated for keratoconus/corneal ectasia utilizing topographic guided ablation photorefractive keratectomy (PRK) for treatment of corneal higher-order aberrations and refractive error followed immediately by 15-minute cross-linking were examined retrospectively. Six-month results were analyzed via measurement of vision, refraction, residual higher-order aberrations (HOAs), residual lower-order and higher-order aberrations, as well as for loss or gains of lines of best-corrected visual acuity. RESULTS: All eyes save one had reduction in K1, K2, K Max, K Mean. All eyes had reduction in manifest astigmatism, Contoura-measured astigmatism, higher-order aberrations, higher-order aberrations grouped with lower-order aberrations (Grouped). Four eyes had lost 1–2 lines of vision, mainly to corneal haze formation, 17 eyes gained lines of vision, and 15 eyes equaled their pre-op best-corrected visual acuity. Eight eyes from four sample patients have their data included in this manuscript to demonstrate the procedure and the outcomes. CONCLUSION: Treatment with WaveLight Contoura combined with 15-minute corneal cross-linking is an effective and safe treatment for keratoconus and should be considered a primary treatment to prevent corneal transplant as well as improve vision and corneal irregularity.