Outcomes of Conductive Keratoplasty Combined with Corneal Crosslinking in Advanced Ectatic Corneal Disease

Outcomes of Conductive Keratoplasty Combined with Corneal Crosslinking in Advanced Ectatic Corneal Disease

To assess the effectiveness of a novel treatment for patients with advanced corneal ectasia and loss of visual acuity (VA). Conductive keratoplasty (CK) is performed to improve VA followed by epithelium-on (epi-on) corneal crosslinking (CXL) to stabilize the cornea after CK. Retrospective, explorato...

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Bibliographic Details
Published in:Clinical ophthalmology (Auckland, N.Z.) Vol. 15; pp. 1317 - 1329
Main Authors: Sinjab, Mazen M, Rubinfeld, Roy S, Wagner, Kirsten, Parsons Jnr, Edward C, Cummings, Arthur B, Belin, Michael W
Format: Journal Article
Language:English
Published: New Zealand Dove Medical Press Limited 01-01-2021
Taylor & Francis Ltd
Dove
Dove Medical Press
Subjects:
conductive keratoplasty
Contact lenses
Cornea
corneal crosslinking
cross linking
Crosslinked polymers
Disease
ecta-sia
keratoconus
Lasers
Medical research
Medicine, Experimental
Original Research
Patients
thermokeratoplasty
Transplants & implants
Maryland
Virginia
California
corneal crosslinking
keratoconus
ectasia
CK
crosslinking
conductive keratoplasty
thermokeratoplasty
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Summary:To assess the effectiveness of a novel treatment for patients with advanced corneal ectasia and loss of visual acuity (VA). Conductive keratoplasty (CK) is performed to improve VA followed by epithelium-on (epi-on) corneal crosslinking (CXL) to stabilize the cornea after CK. Retrospective, exploratory cohort study. Patients with keratoconus or postsurgical ectasia and best spectacle-corrected distance VA (CDVA) ≤ 20/40 were included. Conductive keratoplasty was performed (ViewPoint CK System, Refractec, Inc., Bloomington, MN); followed a day later by epi-on CXL (CXLUSA/CXLO, Bethesda, MD/CXLO Encinitas, CA). Measures included uncorrected distance visual acuity (UDVA) and CDVA, as well as refractive and tomographic measures and tomographic indices. Data from 50 eyes of 45 patients were analyzed. Mean follow-up was 15.1 ± 12.2 months (range: 2 to 51). Overall, UDVA and CDVA improved postoperatively. Subjective refraction and tomographic metrics did not show consistent changes, but changes in tomographic indices were associated with treatment follow-up time. At the 1-year visit, mean UDVA significantly improved over baseline ( = 0.009) by approximately 3 lines; mean CDVA improved significantly (P = 10 ) by approximately 2 lines. No eye lost lines of CDVA. Change in the Index of Surface Variance (ISV) was associated with treatment, and the D-Index trended over follow-up time. Conductive keratoplasty with a proprietary epi-on CXL treatment improved vision in patients with advanced ectasia This CK/epi-on CXL treatment offers the possibility of improved VA for patients with compromised vision due to ectasia.
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ISSN:1177-5467
1177-5483
1177-5483
DOI:10.2147/OPTH.S259012