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Prophylactic collagen cross-linking (pCXL) in high risk (HR) LASIK

Prophylactic collagen cross-linking (pCXL) in high risk (HR) LASIK. World Cornea Congress, Boston 2010. John Kanellopoulos, MD Clinical Associate Professor NYU Medical School, NY Director, Laservision.gr Institute, Athens, Greece.

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Prophylactic collagen cross-linking (pCXL) in high risk (HR) LASIK

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  1. Prophylactic collagen cross-linking (pCXL) in high risk (HR) LASIK World Cornea Congress, Boston 2010 • John Kanellopoulos, MD • Clinical Associate Professor NYU Medical School, NY • Director, Laservision.gr Institute, Athens, Greece Finalcial Interest: Travel expense reimbursement from Wavelight (in the past) Kanellopoulos, MD www.brilliantvision.com

  2. In our long experience with cross-linking since 2002 we have treated over 100 ectasia cases and over 700 KCN cases We have subsequently employed CXL as a prophylactic measure in over 150 primary refractive surgery cases (PRK and LASIK) In this study we evaluated the safety and efficacy of ultraviolet A irradiation (UVA) cross-linking (CXL) combined at the completion for high risk myopic LASIK casesSetting: Laservision.gr Institute , Athens, Greece Purpose: Kanellopoulos, MD www.brilliantvision.com

  3. Methods • 25 LASIK cases treated with a FS60 100 micron Intralase flap and the Wavelight excimer Pentacam –guided platform were evaluated peri-operatively for UCVA, BSCVA, refraction, keratometry (K), topography(T), total and flap pachymetry (tP & fP), endothelium(ECC). • All eyes at the completion LASIK had 0.1% riboflavin solution within the flap interface and CXL with 7mW/cm2for 10 minutes. • Mean follow up was 1.5 years (1 to 3) Kanellopoulos, MD www.brilliantvision.com

  4. Case example 31y/o: -7.50 -2.5 @165Pre-(537um) >BSCVA 20/30 Immediately and next day 1 month (383um) > 5 months(408um) UCVA 20/20 > Kanellopoulos, MD www.brilliantvision.com

  5. Video Kanellopoulos, MD www.brilliantvision.com

  6. Results • K: 44.5D to 36.25D, • Flap P: 105, • Total P: 525 to 405, • ECC: 2750 to 2800. • No ectasia • 1 1/2 year follow-up (1-2.5) Mean values: • UCVA changed from 0.2 to 1.0, • BSCVA 0.9 to 1.2, • spherical equivalent -7.5D to -0.2D, • Cyl -1.75 to -0.37 Kanellopoulos, MD www.brilliantvision.com

  7. Conclusions • Prophylactic collagen cross-linking (CXL) for “high risk” LASIK cases appears to be a safe and effective adjunct treatment against potential ectasia. • This application may be viewed as the prophylactic customization of the biomechanic behavior of the cornea collagen. • It appears not to affect our treatment nomogram as all cases were within treatment goal as with this novel technique we did not encountered any refractive surprises • This adjunct cross-linking technique may have wider application in LASIK surgery in the future and potentially in therapeutic LASIK surgery under 18 years of age • Not tested- but may make flap re-opening difficult. Kanellopoulos, MD www.brilliantvision.com

  8. Thank you www.brilliantvision.com Kanellopoulos MD www.brilliantvision.con

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