The management of cornea blindness from severe corneal scarring, with the Athens Protocol (transepithelial topography-guided PRK therapeutic remodeling, combined with same-day, collagen cross-linking).

Clinical Ophthalmology
Anastasios John Kanellopoulos

Abstract

To evaluate the safety and efficacy of combined transepithelial topography-guided photorefractive keratectomy (PRK) therapeutic remodeling, combined with same-day, collagen cross-linking (CXL). This protocol was used for the management of cornea blindness due to severe corneal scarring. A 57-year-old man had severe corneal blindness in both eyes. Both corneas had significant central scars attributed to a firework explosion 45 years ago, when the patient was 12 years old. Corrected distance visual acuity (CDVA) was 20/100 both eyes (OU) with refraction: +4.00, -4.50 at 135° in the right eye and +3.50, -1.00 at 55° in the left. Respective keratometries were: 42.3, 60.4 at 17° and 35.8, 39.1 at 151.3°. Cornea transplantation was the recommendation by multiple cornea specialists as the treatment of choice. We decided prior to considering a transplant to employ the Athens Protocol (combined topography-guided partial PRK and CXL) in the right eye in February 2010 and in the left eye in September 2010. The treatment plan for both eyes was designed on the topography-guided wavelight excimer laser platform. Fifteen months after the right eye treatment, the right cornea had improved translucency and was topographically stable with uncorr...Continue Reading

Citations

Aug 20, 2014·Journal of Cataract and Refractive Surgery·Hani SaklaCésar Albarrán-Diego
Aug 20, 2014·Journal of Cataract and Refractive Surgery·John A Kanellopoulos
Nov 27, 2018·Journal of Cataract and Refractive Surgery·Karl Stonecipher
Jun 6, 2013·Current Opinion in Ophthalmology·Michelle K Nguyen, Roy S Chuck
Sep 8, 2017·Journal of Refractive Surgery·Nir SorkinDavid S Rootman

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