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Comparison of Femto-LASIK With Combined Accelerated Cross-linking to Femto-LASIK in High Myopic Eyes: A Prospective Randomized Trial

2019; Elsevier BV; Volume: 211; Linguagem: Inglês

10.1016/j.ajo.2019.10.024

1879-1891

Thomas Kohnen, Christoph Lwowski, Eva Hemkeppler, Nina de’Lorenzo, Kerstin Petermann, R. Förster, Michael H. Herzog, Myriam Böhm,

Ocular Surface and Contact Lens

HighlightsLASIK Xtra (laser–assisted in situ keratomileusis combined with intraoperative cross-linking) offers a potential benefit regarding myopic regression without compromising on safety and efficiency compared to conventional LASIK in high myopic patients after 12 months. It could be a promising treatment option in high myopic patients seeking to gain spectacle independence.AbstractPurposeTo evaluate the safety and efficacy of femtosecond (fs) laser–assisted in situ keratomileusis (LASIK) combined with accelerated corneal cross-linking (LASIK Xtra) compared to conventional fs-LASIK (convLASIK) in high myopic patients.DesignProspective, randomized, fellow-eye controlled clinical trial.MethodsSetting: Department of Ophthalmology, Goethe University, Frankfurt/Germany. StudyPopulation: Twenty-six patients with high myopia and/or myopic astigmatism received randomized treatment with LASIK Xtra (30 mW/cm2, 90 seconds with continuous ultraviolet-A) in 1 eye and convLASIK in the other eye. MainOutcomeMeasures: Uncorrected distance visual acuity (UDVA), best spectacle-corrected VA (BSCVA), manifest refractive spherical equivalent (MRSE), endothelial cell count (ECC), and corneal thickness.ResultsThe UDVA improved from 1.26 ± 0.13 logMAR preoperative to −0.02 ± 0.15logMAR in LASIK Xtra eyes and from 1.27 ± 0.12 logMAR to 0.01 ± 0.15 logMAR in the convLASIK eyes (P > .05). The MRSE changed from −7.35 ± 1.15 diopters (D) and −7.5 ± 1.12 D to −0.17 ± 0.43 D and −0.25 ± 0.46 D, respectively. There was no significant difference in outcomes between both groups during the 12 months follow-up except for the convLASIK eyes' showing slightly better BSCVA after 1 week (P < .05). ConvLASIK eyes revealed a nonsignificant trend toward myopic regression from 3 to 12 months postoperative with a change in MRSE of −0.15 D compared to −0.1 D in LASIK Xtra eyes. Topography showed stability of corneal curvature with no signs of keratectasia in both groups at 12 months.ConclusionWhile apparently safe, LASIK Xtra showed no advantages over conventional LASIK. At 12 months, both groups showed no difference regarding UDVA and refractive stability, and no signs of keratectasia.