Central Corneal Regularization – Optimization of Uncorrected Visual Acuity in Keratoconus Patients

Abstract

Background: Combined excimer laser correction and corneal cross-linking is a promising concept in treating keratoconus patients. Central corneal regularization represents advanced topography-guided custom ablation for ectatic corneas, aiming at correcting irregular astigmatism and at increasing the optical regularity of the corneal surface.

Patients and Methods: In a prospective single centre study, 10 keratoconus patients underwent combined treatment with corneal cross-linking and central corneal regularization by an iRES-Laser. Uncorrected visual acuity at 1 and 3 months postoperatively represented the primary endpoint.

Results: Mean preoperative uncorrected decimal visual acuity was 0.15 (± 0.28 standard deviation). Mean postoperative visual acuity was 0.28 (± 0.47) at one month and 0.24 (± 0.25) at three months, respectively.

Conclusions: Combined corneal cross-linking and central corneal regularization treatment has the potential to achieve a clinically significant improvement of uncorrected visual acuity.

Zusammenfassung

Hintergrund: Die Kombination von Excimerlaser-Behandlung und kornealem Cross-linking ist ein vielversprechendes Konzept für die Behandlung von Keratokonuspatienten. Central Corneal Regularization stellt eine neuartige, topografiegeführte Laserabtragung für ektatische Hornhäute dar, die auf eine optimal reguläre Oberfläche abzielt.

Patienten und Methoden: In einer prospektiven monozentrischen Studie wurden 10 Keratokonuspatienten einer kombinierten Behandlung aus kornealem Cross-linking und Central Corneal Regularization mit dem iRES-Laser unterzogen. Primärer Endpunkt war die Entwicklung des unkorrigierten Visus 1 und 3 Monate nach Behandlung.

Ergebnisse: Der mittlere unkorrigierte Dezimalvisus betrug präoperativ 0,15 (± 0,28 Standardabweichung). Postoperativ betrug der Visus 0,28 (± 0,47) nach einem bzw. 0,24 (± 0,25) nach 3 Monaten.

Schlussfolgerungen: Die Kombination aus kornealem Cross-linking und Central Corneal Regularization hat das Potenzial, den unkorrigierten Visus von Keratokonuspatienten klinisch signifikant zu verbessern.

Key words

central corneal regularization - surface ablation - cross-linking - keratoconus

Schlüsselwörter

Central Corneal Regularization - Oberflächenlaser - Cross-linking - Keratokonus

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