Combined corneal CXL and photorefractive keratectomy for treatment of keratoconus: a review
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Mansour M. Al-Mohaimeed. Department of Ophthalmology, College of Medicine, Qassim University, Qassim, PO Box 6655, Buraidah 51452, Kingdom of Saudi Arabia. drmohaimeed@qumed.edu.sa

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    Abstract:

    Keratoconus and iatrogenic keratectasia are the corneal ectatic disorders occurring due to biomechanical weakening of the cornea resulting in distorted images, myopia, and irregular astigmatism. Corneal collagen cross-linking (CXL) is performed to arrest keratoconus successfully. The main aim of this review is to discuss the safety and efficacy of the adjuvant therapies, such as the combination of CXL and photorefractive keratectomy (PRK) for the treatment of corneal ectatic disorders. A comprehensive literature search was performed using PubMed, MEDLINE, and Scopus using keywords ‘collagen’ ‘keratoconus’, ‘keratectasia’, ‘collagen cross-linking’, and ‘photorefractive keratectomy’. Search results were restricted to clinical studies published in English. Corneal CXL effectively arrests the progression of keratoconus by enhancing corneal rigidity. However, functional vision is not improved by cross-linking. Combining CXL to refractive surgeries such as topography-guided PRK or transepithelial PRK is found to be a safe and effective method in providing corneal stability as well as significantly improving functional visual acuity with few minor complications. This combined technique also prevents regression of keratoconus and reduce the risk of keratectasia. CXL combined with PRK is a promising therapeutic approach in ophthalmology that can be successfully used to treat progressive keratoconus and other corneal ectatic disorders and to enhance visual acuity.

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Al-Mohaimeed MM. Combined corneal CXL and photorefractive keratectomy for treatment of keratoconus: a review. Int J Ophthalmol 2019;12(12):1929-1938

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Publication History
  • Received:March 01,2019
  • Revised:May 29,2019
  • Adopted:
  • Online: November 06,2019
  • Published: