5-year efficacy of all surface laser ablation with cross-linking(ASLA-XTRA)for the treatment of myopia

Background:The purpose of our study is to examine the long(5-year)efficacy of the all surface laser ablation(ASLA)combined with accelerated cross-linking(CXL)for the treatment of myopia without the use of mitomycin-C(MMC).Methods:This retrospective study consisted of 202 eyes of 118 myopic(SD:2.41,range:−1.50 to−12.75 D)patients(44 males,74 females).Mean age was 28.50 years(SD:6.45,range:18 to 51 years)that underwent ASLA with accelerated CXL for the treatment of their myopia.Results:The patients underwent routine postoperative assessment on the 1st,3rd,7th day and in the 1st,3rd,6th and 12th month,30th month(±6 months),4th and 5th year.The mean spherical equivalent(SEq)refractive error changed from−6.41±2.41 D preoperatively to−0.02±0.53 D at 5 years postoperatively.The haze score was 0.18,0.25 and 0.28 at 1,3 and 6 months postoperatively.At 12 months after the treatment,no eyes had significant corneal haze and in all the following postoperative time intervals the haze traces were gone.Conclusion:ASLA combined with accelerated CXL(ASLA-XTRA)appears to be safe,efficacious and offering very good refractive results.The potential additional benefits of this modality are the stabilizing effect of the refraction and its sterilization effect on the treated cornea without the potential side effects of MMC.

Central corneal regularization (CCR): an alternative approach in keratoconus treatment

Background:To evaluate the safety and efficacy of an approach that combines corneal customized transepithelial therapeutic ablation to treat irregular corneal optics and accelerated corneal collagen cross-linking(CXL)to strengthen the corneal tissue and stop the progression of keratoconus.The transepithelial therapeutic ablation applied a novel concept named central corneal regularization(CCR)which could correct the corneal morphological irregularities and the eye’s spherocylindrical refractive error with minimal stromal tissue removal.Methods:Retrospective study.Eyes that underwent CCR combined with CXL were evaluated preoperatively and up to 12 months postoperatively for visual acuity,subjective refraction,corneal haze,pachymetry and maximum keratometry(Kmax).Results:Twenty four eyes of 24 patients with a mean age of 28.92±9.88 years were treated.The mean spherical equivalent(SE)refractive error changed from−0.74±1.17 D preoperatively to−1.05±1.52 D at 12 months postoperatively.The mean uncorrected distance visual acuity(UDVA)and corrected distance visual acuity(CDVA)improved.No eye lost lines of CDVA,21 had a mean improvement of 3.21 lines.The mean cylinder error and Kmax value dropped from−3.06±1.83 D and 51.38±3.29 D to−1.04±0.80 D and 48.70±2.58 D,respectively.The mean haze score at 3,6 and 12 months was 0.56,0.19 and 0.06,respectively.Conclusions:CCR combined with CXL offers promising results as a safe and effective treatment in keratoconic patients.