Corneal collagen crosslinking for ectasia after laser in situ keratomileusis: Long-term results

PURPOSE: To report the long-term results of corneal collagen crosslinking (CXL) treatment for post-laser in situ keratomileusis (LASIK) ectasia. SETTINGS: Turkiye Hospital Eye Clinic and Fatih University Medical Faculty, Department of Ophthalmology, Istanbul, Turkey. DESIGN: Retrospective case series study. METHODS: Consecutive patients with ectasia after LASIK were treated with CXL. The main outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical and cylindrical refractions, and simulated keratometry (K) values. RESULTS: The study enrolled 20 eyes (14 patients; 7 women) with a mean age of 34.8 years ± 6.0 (SD) (range 25 to 45 years) and mean follow-up of 42 months (range 36 to 60 months). The UDVA and CDVA improved significantly, from 0.78 ± 0.61 logMAR to 0.53 ± 0.36 logMAR (P=.007) and from 0.27 ± 0.23 logMAR to 0.19 ± 0.13 logMAR, respectively (P≤.028). No eye lost 1 or more Snellen lines of UDVA or CDVA. Although the mean spherical refraction was not significantly different at the last visit (P=.074), the mean cylindrical refraction decreased significantly (P=.036). The maximum K value decreased from 46.0 ± 4.4 diopters (D) at baseline to 45.6 ± 3.8 D at the last visit (P=.013). By the last visit, the maximum K value decreased (≥1.0 D) in 5 eyes and remained stable in 15 eyes. No serious complications occurred. CONCLUSIONS: Corneal collagen crosslinking yielded long-term stability in cases with post-LASIK corneal ectasia without significant side effects. Improvements in visual acuity, cylindrical refraction, and maximum K values occurred. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.