Surgical Procedure, Unspecified Clinical Trial
Official title:
Two Years Follow up of Corneal Cor Cross-linking and Refractive Surface Ablation in Patients With Asymmetric Corneal Topography
The purpose of this study is to evaluate safety and efficacy of corneal cross-linking and photorefractive keratectomy for refractive correction in patients with bilateral asymmetric topography.
Corneal cross-linking (CXL) by the photosensitizer, riboflavin (vitamin B2), and ultraviolet
A (UVA) light increases corneal rigidity and has been described as an effective method for
stabilizing the cornea in patients with progressive keratoconus. The photochemical reaction
in this procedure causes the collagen to form additional covalent connections between its
fibers, which stabilizes the stromal collagen fibers, improving the collagen's structure and
the cornea rigidity. It is a relatively safe procedure with low rates of complications
Photorefractive keratectomy (PRK) it is a traditional technique for refractive surgery. In
cases of irregular corneas or re-operation normally the favorite ablation profile chosen is
the guided surgery, topography guided or wavefront guided, showing better results. This
technique is also relatively safe procedure with low rates of complications. One of the most
unwanted complications of this surgery and also rare is corneal ectasia.
Combining PRK and CXL is already done in patients with keratoconus and suspected
keratoconus.
This combined procedure uses the principle that CXL stiffen the cornea making it possible to
reduce corneal thickness with PRK without weakening corneal strength. Literature show better
results, in keratoconus, with simultaneous procedures. Guedj et al performed PRK in
keratoconus suspects and within 5 years he did not found any corneal ectasia.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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