The novel treatment described herein may become an alternative to the Athens protocol, serving potentially the same purpose of normalizing corneal irregularity with customized toric and spherical infrared laser cornea refractive modification and stabilizing the ectasia with combined corneal collagen cross-linking, without tissue removal or corneal thinning.
Although not studied herein, the pachymetry requirements of such a treatment may be as low as 350 μm in vivo, allowing its application in extreme ectasia. The main difference between this technique and the Keraflex is in essence the lack of epithelial injury and highly titratable nature of the laser application and therefore corneal shrinkage.
This novel laser and corneal collagen cross-linking treatment appears to be able to both flatten and steepen the cornea, depending on the diameter and depth of laser application, and coupled with transepithelial collagen cross-linking, may provide a novel nonincisional, nonimplanted, sutureless, and essentially pain-free procedure (due to no epithelium defect). Very little discomfort is anticipated in real clinical use postoperatively, and there is a very low risk of infectious complications involving the cornea.
It looks very interesting (from first glance lower risk) but obviously at a very, very early stage.