Combined small-incision lenticule extraction and intrastromal corneal collagen crosslinking to  treat mild XXXX : Long-term follow-up.

@entity1 @entity9042 @entity8728
PURPOSE: To report visual, refractive, and topographic outcomes of sequential, same-day small-incision lenticule extraction and intrastromal corneal collagen crosslinking (CXL) in eyes with mild @entity9042 . SETTING: Institute of Ophthalmology Conde de Valenciana, Mexico City, Mexico. DESIGN: Prospective interventional case series. METHODS: Fifteen eyes with forme fruste @entity9042 and/or irregular corneas, corrected distance visual acuity 20/40 or better, stable refraction of at least 1 year, age 18 years or older, and residual corneal thickness of greater tan 400  m before performing collagen crosslinking were studied. @entity1 were treated with small-incision lenticule extraction followed by intrastromal injection of @entity8728 inside the pocket. Ultraviolet A light with a wavelength of 370 nm to 3 mW/cm(2) was applied for 30 minutes. Follow-up was done at 1 day, at 1 week, and at 1, 3, 6, 12, 18, and 24 months. RESULTS: Eight @entity1 were included in the study. The mean age was 29.5 years    5.5 (SD) (range 20 to 36 years). Twenty-four months of follow-up were completed in 13 eyes, and 12 months were completed in 2 eyes. Preoperative uncorrected distance visual acuity improved from 1.6    0.3 LogMAR (Snellen 20/796) to postoperative 0.12    0.20 LogMAR (Snellen 20/26) and was statistically significant (P < .001). Best-corrected distance visual acuity did not change significantly (P = .186), from 0.006    0.02 LogMAR (Snellen 20/20) preoperatively to 0.04    0.05 LogMAR (Snellen 20/21) postoperatively, and spherical equivalent improved from -4.3    1.02 preoperatively to 0.2    0.66 (P < .001). CONCLUSION: Although further follow-up and larger samples are needed to fully confirm these findings, the results suggest that combined small-incision lenticule extraction and intrastromal corneal collagen crosslinking are a promising treatment option for @entity1 for whom conventional laser refractive surgery is contraindicated. FINANCIAL DISCLOSURE: Drs. Ramirez-Miranda and Navas are consultants to Carl Zeiss Meditec. No other author has a financial or proprietary interest in any material or method mentioned.
