Comparison of Femto-LASIK with combined Accelerated Crosslinking to Femto-LASIK in high myopic eyes: a prospective randomized trial.

Abstract

PURPOSE\nTo evaluate the safety and efficacy of femtosecond (FS) laser-assisted in situ keratomileusis (LASIK) combined with accelerated corneal crosslinking (LASIK Xtra) compared to conventional FS-LASIK (convLASIK) in high myopic patients.\n\n\nDESIGN\nProspective, randomized, fellow-eye controlled, clinical trial.\n\n\nSETTING\nDepartment of Ophthalmology, Goethe University, Frankfurt/Germany.\n\n\nSTUDY POPULATION\n26 patients with high myopia and/or myopic astigmatism received randomized treatment with LASIK Xtra (30 mW/cm2, 90 seconds with continuous UVA) in one eye and convLASIK in the other eye.\n\n\nMAIN OUTCOME MEASURES\nUncorrected distance visual acuity (UDVA), best spectacle corrected VA (BSCVA), manifest spherical equivalent (MRSE), endothelial cell count (ECC) and corneal thickness.\n\n\nRESULTS\nThe UDVA improved from 1.26±0.13logMAR preoperative to -0.02±0.15logMAR in LASIK Xtra eyes and from 1.27±0.12logMAR to 0.01±0.15LogMAR in the convLASIK eyes (p>0.05). The MRSE changed from -7.35±1.15D and -7.5±1.12D to -0.17±0.43D and -0.25±0.46D, respectively. There was no significant difference in outcomes between both groups during the 12 months follow-up except the conLASIK eyes showing slightly better BSCVA after 1 week (p<0.05). ConvLASIK eyes revealed a non-significant trend towards myopic regression from 3 to 12 months postoperative with a change in MRSE of -0.15D compared to -0.1D in LASIK Xtra eyes. Topography showed stability of corneal curvature with no signs of keratectasia in both groups at 12 months.\n\n\nCONCLUSION\nWhile apparently safe, LASIK Xtra showed no advantages over conventional LASIK. At 12 months, both groups showed no difference regarding UDVA and refractive stability, and no signs of keratectasia.