Results of Corneal Collagen Cross-Linking in Patients with Corneal Ectasia after Laser Refractive Surgery-a Prospective Study.

Purpose: To evaluate the safety and efficacy of epithelium-off (epi-off) corneal cross-linking (CXL) in patients with post-LASIK corneal ectasia (PLE) Setting: Private clinical practice Design: Prospective clinical trial Methods: 82 eyes of adult patients post-LASIK, ages 21-67, with a topography pattern consistent with corneal ectasia, corrected distance visual acuity (CDVA) worse than 20/20, and minimum corneal pachymetry > 400 mu m underwent epi-off CXL. Exclusion criteria were patients with corneas that were thinner than 400 mu m or demonstrated central corneal scarring, history of herpetic eye disease, pregnancy or nursing. Follow up examinations of spherical equivalent, uncorrected distance visual acuity (UDVA), CDVA, steep keratometry (K-Steep) and minimum pachymetry occurred on different but highly overlapping subsets of the operated eyes yearly until 5 years post-CXL. Results: Over the 5 years of follow up, spherical equivalent did not significantly change while UCVA and CDVA stabilized or improved to a non-significant degree. K-Steep and minimum pachymetry continued to be decreased to a statistically significant degree (p < 0.05 at 5 years). Conclusions: CXL in PLE patients is safe and efficacious: it halts progression of PLE and may improve visual function. K-Steep and minimum pachymetry decrease post-CXL. Patients with PLE should be encouraged to stop progression of the disease by undergoing epi-off CXL once progression is established.