Selective transepithelial ablation with simultaneous accelerated corneal crosslinking for corneal regularization of keratoconus: STARE-X protocol

Miguel Rechichi, Cosimo Mazzotta, Giovanni William Oliverio (Coresponding Author), Vito Romano, Davide Borroni, Marco Ferrise, Simone Bagaglia, Soosan Jacob, Alessandro Meduri

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

PURPOSE: To evaluate the changes in refractive outcomes and corneal aberrations in central and paracentral keratoconus after selective transepithelial topography-guided photorefractive keratectomy combined with accelerated corneal crosslinking (STARE-X). SETTINGS: Centro Polispecialistico Mediterraneo, Siena Crosslinking Center, and University of Messina, Italy. DESIGN: Prospective, interventional, multicentric study. METHODS: Patients were subdivided into 2 groups: Group 1 with cone located within the central 3 mm zone (50 eyes) and Group 2 (50 eyes) with cone located outside the central 3 mm zone. Follow-up was 2 years at least for all eyes. Outcome parameters included uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA). Corneal tomography and corneal wavefront aberrations were assessed and compared before and 2 years after the treatment. RESULTS: 100 eyes of 100 patients underwent STARE-X protocol. At 2 years, UDVA and CDVA improved, and sphere, cylinder, and Kmax reduced after treatment in both groups (P < .001, respectively). Moreover, a statistically significant reduction was observed of total higher-order aberrations root main square (RMS), coma RMS, and spherical aberration RMS in both groups (P < .001, respectively). However, CDVA improved more in Group 1 than in Group 2 (P < .02). CONCLUSIONS: The STARE-X protocol demonstrated effective results in halting keratoconus progression and improving corneal regularity with a safe and effective profile. STARE-X improved both visual acuity and corneal aberration at 2 years. Longer follow-up studies are warranted to observe further long-term CXL flattening effect on the cone.

Original languageEnglish
Pages (from-to)1403-1410
Number of pages8
JournalJournal of Cataract and Refractive Surgery
Volume47
Issue number11
DOIs
Publication statusPublished - 1 Nov 2021

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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