Advanced topography-guided (OcuLink) treatment of irregular astigmatism after epikeratophakia in keratoconus with the WaveLight excimer laser.

Abstract

PURPOSE:

To evaluate the feasibility, safety, and predictability of treatment for high irregular astigmatism with advanced topography-guided laser epithelial keratomileusis in symptomatic eyes after epikeratophakia (EP) for keratoconus.

METHODS:

In a prospective case series, 10 consecutive eyes (10 patients) with high irregular astigmatism after epikeratophakia for keratoconus received OcuLink laser-assisted subepithelial keratectomy (LASEK) using the Allegretto Wave excimer laser. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifestation and refraction, corneal topographic examination with asphericity, and regularity were evaluated. All patients could not tolerate contact lens wear and had subjective symptoms.

RESULTS:

The UCVA improved from 0.61 ± 0.27 logarithm of the minimum angle of resolution (logMAR) (range, 0.3-1.0 logMAR) to 0.27 ± 0.07 logMAR (range, 0.2-0.4 logMAR), and the BSCVA improved from 0.25 ± 0.14 to 0.15 ± 0.09 logMAR (range, 0-0.3 logMAR) at 6 months after surgery. One patient had reduced UCVA (1 line), but no patients had reduced BSCVA. The refractive cylinder improved from -3.82 ± 2.43 diopters (D) (range, -0.75 to -7.75 D) to -1.43 ± 0.95 D (range, -0.25 to -2.50 D). The index of surface variance (an indicator of corneal surface irregularity) reduced from 115.1 ± 21.1 (range, 90-153) to 68.4 ± 18.2 (range, 39-95). Subjective symptoms, such as glare, halos, ghost images, starbursts, and monocular diplopia, were either not present or obviously alleviated.

CONCLUSIONS:

Advanced topography-guided (OcuLink) LASEK can significantly reduce irregular astigmatism and increase the UCVA and BSCVA.

• Authors: Hua Gao, Weiyun Shi, Mingna Liu, Yan Gao, Lixin Xie
• Journal: Cornea (Cornea) Vol. 31 Issue 2 Pg. 140-4 (Feb 2012) ISSN: 1536-4798 [Electronic] United States
• PMID: 22094961 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Astigmatism (etiology, surgery)
• Corneal Topography (methods)
• Epikeratophakia (adverse effects)
• Feasibility Studies
• Female
• Humans
• Keratoconus (complications)
• Keratomileusis, Laser In Situ (methods)
• Lasers, Excimer (therapeutic use)
• Male
• Postoperative Complications
• Prospective Studies
• Reoperation
• Visual Acuity
• Young Adult