Application of a Revised Tissue Saving Protocol for Combined Topography-Guided Photorefractive Keratectomy and Cross-Linking in a Cohort Having Pellucid Marginal Degeneration
Mohamed Omar Yousif,1,2 Rania Serag Elkitkat,1,3– 5 Mohamed Nabil Hamza,1 Noha Abdelsadek Alaarag1 1Ophthalmology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Maadi Eye Subspecialty Center, Cairo, Egypt; 3Watany Eye Hospital, Cairo, Egypt; 4Watany Research and Development Ce...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2024-02-01
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| Series: | Clinical Ophthalmology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/application-of-a-revised-tissue-saving-protocol-for-combined-topograph-peer-reviewed-fulltext-article-OPTH |
| _version_ | 1797335745729396736 |
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| author | Omar Yousif M Elkitkat RS Hamza MN Abdelsadek Alaarag N |
| author_facet | Omar Yousif M Elkitkat RS Hamza MN Abdelsadek Alaarag N |
| author_sort | Omar Yousif M |
| collection | DOAJ |
| description | Mohamed Omar Yousif,1,2 Rania Serag Elkitkat,1,3– 5 Mohamed Nabil Hamza,1 Noha Abdelsadek Alaarag1 1Ophthalmology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Maadi Eye Subspecialty Center, Cairo, Egypt; 3Watany Eye Hospital, Cairo, Egypt; 4Watany Research and Development Center, Watany Eye Hospital, Cairo, Egypt; 5Ophthalmology Department, Faculty of Medicine, MTI University, Cairo, EgyptCorrespondence: Rania Serag Elkitkat, Email raniaselkitkat@med.asu.edu.eg; rania.serag@yahoo.comPurpose: To evaluate the efficiency, safety, and stability of a revised tissue-saving treatment protocol in a cohort having pellucid marginal degeneration (PMD).Methods: A retrospective cohort study was conducted on patients with PMD and no previous treatments. A revised protocol of topo-guided photorefractive keratectomy to be followed by customized phototherapeutic keratectomy and then corneal crosslinking was evaluated by comparing the pre and postoperative outcomes regarding visual (subjective refraction) and topographic (using data from Sirius CSO topography software) outcomes.Results: There were both statistically significant and clinically relevant improvements in the postoperative parameters, where each of the unaided and corrected visual acuity, spherical equivalent, refractive cylinder, K readings, topographic cylinder, inferior minus superior difference at the 2- and 4- mm diameters, coma aberration, and higher order aberrations were significantly better postoperatively (all p values were less than 0.01, except for maximum k readings where the p-value was 0.017). The safety and efficacy indices for the surgical procedure were remarkably high (1.53 ± 0.70 and 0.90 ± 0.32, respectively).Conclusion: Our proposed tissue-saving protocol (which showed satisfactory results in keratoconus cases according to a previously published article by our research team) has proven its successful outcomes (both topographically and visually) in cases of PMD, which is a rare ectatic entity with guarded prognosis using the available conventional ectasia treatment modalities.Keywords: pellucid marginal degeneration, recent treatment options for PMD, combined PTK and CXL for PMD, tissue saving protocol for PMD treatment, revised cross-linking with PTK for PMD |
| first_indexed | 2024-03-08T08:42:50Z |
| format | Article |
| id | doaj.art-ea911a0f686c463d93bca1e8c454e716 |
| institution | Directory Open Access Journal |
| issn | 1177-5483 |
| language | English |
| last_indexed | 2024-03-08T08:42:50Z |
| publishDate | 2024-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-ea911a0f686c463d93bca1e8c454e7162024-02-01T17:59:27ZengDove Medical PressClinical Ophthalmology1177-54832024-02-01Volume 1830331190100Application of a Revised Tissue Saving Protocol for Combined Topography-Guided Photorefractive Keratectomy and Cross-Linking in a Cohort Having Pellucid Marginal DegenerationOmar Yousif MElkitkat RSHamza MNAbdelsadek Alaarag NMohamed Omar Yousif,1,2 Rania Serag Elkitkat,1,3– 5 Mohamed Nabil Hamza,1 Noha Abdelsadek Alaarag1 1Ophthalmology department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Maadi Eye Subspecialty Center, Cairo, Egypt; 3Watany Eye Hospital, Cairo, Egypt; 4Watany Research and Development Center, Watany Eye Hospital, Cairo, Egypt; 5Ophthalmology Department, Faculty of Medicine, MTI University, Cairo, EgyptCorrespondence: Rania Serag Elkitkat, Email raniaselkitkat@med.asu.edu.eg; rania.serag@yahoo.comPurpose: To evaluate the efficiency, safety, and stability of a revised tissue-saving treatment protocol in a cohort having pellucid marginal degeneration (PMD).Methods: A retrospective cohort study was conducted on patients with PMD and no previous treatments. A revised protocol of topo-guided photorefractive keratectomy to be followed by customized phototherapeutic keratectomy and then corneal crosslinking was evaluated by comparing the pre and postoperative outcomes regarding visual (subjective refraction) and topographic (using data from Sirius CSO topography software) outcomes.Results: There were both statistically significant and clinically relevant improvements in the postoperative parameters, where each of the unaided and corrected visual acuity, spherical equivalent, refractive cylinder, K readings, topographic cylinder, inferior minus superior difference at the 2- and 4- mm diameters, coma aberration, and higher order aberrations were significantly better postoperatively (all p values were less than 0.01, except for maximum k readings where the p-value was 0.017). The safety and efficacy indices for the surgical procedure were remarkably high (1.53 ± 0.70 and 0.90 ± 0.32, respectively).Conclusion: Our proposed tissue-saving protocol (which showed satisfactory results in keratoconus cases according to a previously published article by our research team) has proven its successful outcomes (both topographically and visually) in cases of PMD, which is a rare ectatic entity with guarded prognosis using the available conventional ectasia treatment modalities.Keywords: pellucid marginal degeneration, recent treatment options for PMD, combined PTK and CXL for PMD, tissue saving protocol for PMD treatment, revised cross-linking with PTK for PMDhttps://www.dovepress.com/application-of-a-revised-tissue-saving-protocol-for-combined-topograph-peer-reviewed-fulltext-article-OPTHpellucid marginal degenerationrecent treatment options for pmdcombined ptk and cxl for pmdtissue saving protocol for pmd treatmentrevised cross-linking with ptk for pmd. |
| spellingShingle | Omar Yousif M Elkitkat RS Hamza MN Abdelsadek Alaarag N Application of a Revised Tissue Saving Protocol for Combined Topography-Guided Photorefractive Keratectomy and Cross-Linking in a Cohort Having Pellucid Marginal Degeneration Clinical Ophthalmology pellucid marginal degeneration recent treatment options for pmd combined ptk and cxl for pmd tissue saving protocol for pmd treatment revised cross-linking with ptk for pmd. |
| title | Application of a Revised Tissue Saving Protocol for Combined Topography-Guided Photorefractive Keratectomy and Cross-Linking in a Cohort Having Pellucid Marginal Degeneration |
| title_full | Application of a Revised Tissue Saving Protocol for Combined Topography-Guided Photorefractive Keratectomy and Cross-Linking in a Cohort Having Pellucid Marginal Degeneration |
| title_fullStr | Application of a Revised Tissue Saving Protocol for Combined Topography-Guided Photorefractive Keratectomy and Cross-Linking in a Cohort Having Pellucid Marginal Degeneration |
| title_full_unstemmed | Application of a Revised Tissue Saving Protocol for Combined Topography-Guided Photorefractive Keratectomy and Cross-Linking in a Cohort Having Pellucid Marginal Degeneration |
| title_short | Application of a Revised Tissue Saving Protocol for Combined Topography-Guided Photorefractive Keratectomy and Cross-Linking in a Cohort Having Pellucid Marginal Degeneration |
| title_sort | application of a revised tissue saving protocol for combined topography guided photorefractive keratectomy and cross linking in a cohort having pellucid marginal degeneration |
| topic | pellucid marginal degeneration recent treatment options for pmd combined ptk and cxl for pmd tissue saving protocol for pmd treatment revised cross-linking with ptk for pmd. |
| url | https://www.dovepress.com/application-of-a-revised-tissue-saving-protocol-for-combined-topograph-peer-reviewed-fulltext-article-OPTH |
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