Dr. PRASHANSA PRAMOD THAKUR

Dr. ROHIT SHETTY, Dr.Pooja Khamar

Abstract

In early keratoconus (KC) with adequate thickness, topo-guided photorefractive keratectomy (TPRK) with cross-linking (CXL) improves visual quality and regularizes the anterior corneal surface. It is inadvisable in thinner corneas, higher grades of KC & decentered cones, where stromal tissue ablation would be unacceptable to achieve a degree of regularization. We devised a novel tissue saving approach-Topoguided removal of epithelium in keratoconus (TREK) 100 keratoconic eyes underwent TREK. Epithelium thickness was measured using OCT & ablation depth was planned upto 25μ beyond the thinnest epithelial thickness. Ablation was centered over the area of highest steepening rather than corneal apex & executed on PTK-CAM module of the Schwind Amaris This was followed by manual removal of surrounding epithelium over 7 mm area and accelerated CXL. The visual, keratometric & aberrometric outcomes were similar to TPRK. Thus, TREK is a safe, effective & novel tissue sparing treatment in KC.