Authors: David T.C. Lin, Simon P. Holland, Albert Covello, Samuel Arba Mosquera
Author Disclosure Block: D.T. Lin: Any direct financial payments including receipt of honoraria; SCHWIND, SHIRE. Any direct financial payments including receipt of honoraria; Description of relationship(s); Speaker, travelling expense, Speaker, travelling expense.S.P. Holland: Membership on advisory boards or speakers’ bureaus; Allergan. Membership on advisory boards or speakers’ bureaus; Description of relationship(s); Advisory Board Member. Funded grants or clinical trials; Alcon. Funded grants or clinical trials; Description of relationship(s); Clinical Trail Investigator.A. Covello: Funded grants or clinical trials; Alcon. Funded grants or clinical trials; Description of relationship(s); Clinical Trail Sub-Investigator.S. Mosquera: All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; SCHWIND. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Description of relationship(s); Employee.

Abstract Body:

Purpose: To evaluate 24 months results of topography-guided Photorefractive Keratectomy (TG-PRK) with simultaneous collagen cross-linking (CXL) for keratoconus
Study Design: Retrospective case series
Methods: A retrospective consecutive series of keratoconic eyes were studied to evaluate the outcomes of Topographic Guided Photorefractive Keratectomy (TG-PRK) with the Schwind Amaris 1050 Excimer laser with simultaneous corneal collagen cross-linking (CXL). Image capture with Sirius and CXL with the Athens protocol. Pre-operative and post-operative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction (MR) and topographic data were analyzed. Cases with sufficient data at 24 months follow-up were included.
Results: 54 eYes had sufficient data at 24 months for analysis. 27 of 54 (50%) showed UDVA ≥20/40 post-operatively. 22 eYes (42%) had improved CDVA and 14 (26%) gained two or more lines while 15 eYes (28%) had loss CDVA with 7 (13%) lost 2 lines or more. Mean astigmatism was reduced from 3.14±1.59D to 2.18±1.79D (p<0.0001). Mean spherical equivalent was improved from -2.54±3.54D to -0.71±2.91D (p<0.0001). 4 eyes showed progression and 5 with haze judged sufficient to reduce CDVA.
Conclusions: Two year results of topography-guided PRK (Schwind Amaris) treatment with CXL for keratoconus show efficacy and safety, with half achieving 20/40 UDVA or better. 42% had improved CDVA and more than a quarter had CDVA improved two or more lines. It provides an alternative to contact lens intolerant keratoconus patients.