{"title":"Comparison of Customized and Standard Corneal Cross-linking for Ectasia After Laser in Situ Keratomileusis.","authors":"Elina M Utti, Kari M Krootila Md","doi":"10.3928/1081597X-20250401-02","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of customized corneal cross-linking (CXL) in ectasia after laser in situ keratomileusis (LASIK).</p><p><strong>Methods: </strong>Thirty-two eyes of 24 patients with post-LASIK ectasia treated with customized CXL were included in this study. Treatment zones with different ultraviolet energy levels were planned according to corneal tomography. A control group of 19 eyes of 14 patients with post-LASIK ectasia received conventional CXL. Patients were prospectively followed up at 1 month, 6 months, and 1 year after the procedure. Subsequent follow-up 2 to 4 years after CXL was obtained from 22 eyes of 18 patients. Corrected distance visual acuity, refraction, and anterior segment optical coherence tomography parameters were compared to preoperative values.</p><p><strong>Results: </strong>After a transient deterioration at 1 month, visual acuity and keratometry stabilized at 6 months in both groups. One year after customized CXL, the visual acuity was significantly better (P< .01), corneal inferior-superior asymmetry decreased (<i>P</i> = .02), and corneal thickness increased (<i>P</i> < .01). These effects were maintained during the 2- to 4-year follow-up. There were no statistically significant changes in refractive outcomes or keratometry at 1 or 2 to 4 years. Decrease in higher order irregularities was seen only after customized CXL, but it did not reach statistical significance. In 1 patient the ectasia continued progressing after customized CXL, giving a failure rate of 4.2%.</p><p><strong>Conclusions: </strong>Customized CXL seems to be as safe as standard CXL in treating progressive post-LASIK ectasia. The results suggest that customized CXL could have a better effect on visual acuity and corneal asymmetry. More studies are needed to verify the advantages of customized method over standard CXL.the <b>[<i>J Refract Surg</i>. 2025;41(5):e451-e459.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"e451-e459"},"PeriodicalIF":3.0000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of refractive surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3928/1081597X-20250401-02","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To evaluate the effect of customized corneal cross-linking (CXL) in ectasia after laser in situ keratomileusis (LASIK).
Methods: Thirty-two eyes of 24 patients with post-LASIK ectasia treated with customized CXL were included in this study. Treatment zones with different ultraviolet energy levels were planned according to corneal tomography. A control group of 19 eyes of 14 patients with post-LASIK ectasia received conventional CXL. Patients were prospectively followed up at 1 month, 6 months, and 1 year after the procedure. Subsequent follow-up 2 to 4 years after CXL was obtained from 22 eyes of 18 patients. Corrected distance visual acuity, refraction, and anterior segment optical coherence tomography parameters were compared to preoperative values.
Results: After a transient deterioration at 1 month, visual acuity and keratometry stabilized at 6 months in both groups. One year after customized CXL, the visual acuity was significantly better (P< .01), corneal inferior-superior asymmetry decreased (P = .02), and corneal thickness increased (P < .01). These effects were maintained during the 2- to 4-year follow-up. There were no statistically significant changes in refractive outcomes or keratometry at 1 or 2 to 4 years. Decrease in higher order irregularities was seen only after customized CXL, but it did not reach statistical significance. In 1 patient the ectasia continued progressing after customized CXL, giving a failure rate of 4.2%.
Conclusions: Customized CXL seems to be as safe as standard CXL in treating progressive post-LASIK ectasia. The results suggest that customized CXL could have a better effect on visual acuity and corneal asymmetry. More studies are needed to verify the advantages of customized method over standard CXL.the [J Refract Surg. 2025;41(5):e451-e459.].
期刊介绍：
The Journal of Refractive Surgery, the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology, has been a monthly peer-reviewed forum for original research, review, and evaluation of refractive and lens-based surgical procedures for more than 30 years. Practical, clinically valuable articles provide readers with the most up-to-date information regarding advances in the field of refractive surgery. Begin to explore the Journal and all of its great benefits such as:
• Columns including “Translational Science,” “Surgical Techniques,” and “Biomechanics”
• Supplemental videos and materials available for many articles
• Access to current articles, as well as several years of archived content
• Articles posted online just 2 months after acceptance.
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