Sequential customized therapeutic keratectomy for corneal apical scar after hyperopic excimer laser refractive surgery

Session Details

Session Title: Photoablation

Session Date/Time: Tuesday 13/09/2016 | 14:00-16:00

Paper Time: 14:00

Venue: Hall C2

First Author: : P.Vinciguerra ITALY

Co Author(s): :    F. Camesasca   R. Vinciguerra   S. Trazza              

Abstract Details

Purpose:

Corneal apical scar after hyperopic excimer laser ablation is a rare but dreadful complication. We present long-term results on its treatment with Sequential Customized Therapeutic Keratectomy (SCTK).

Setting:

Ophthalmology Dept., Humanitas Research Institute, Rozzano, Milan, Italy

Methods:

We included eyes treated with SCTK for apical scar ensuing after hyperopic refractive surgery and causing severe visual impairment, defined as postoperative loss of at least 4 BCVA lines. STCK involved custom, transepithelial ablation aimed at treating mostly corneal aberrations. Intraoperative topography was repeated to visualize attained corneal regularization, and plan further treatment. Excimer laser smoothing with masking fluid was also performed.

Results:

We evaluated 15 eyes of 12 patients, 7 with a one-year follow-up, the others with a minimum two-year follow-up. BCVA increased significantly, starting from 0.53±0.26 and reaching 0.80±0.26 (p<0.01). Mean spherical defect did not change significantly from baseline – from 0.98±4.2 D to 1.3±3.3 D (p>0.05) - demonstrating that SCTK did not induce hyperopic shift. Mean astigmatism decreased with respect to baseline - from -1.34±1.17 D to 0.68±0.71 D – but not significantly (p=0.23).Corneal aberrations showed significant decrease of total RMS, from 2.57±1.92 to 0.80±0.42 µm (p<0.05). No recurrence of apical scar or ectasia were observed.

Conclusions:

This rare and severe complication of refractive surgery can be treated successfully and safely with SCTK even years after initial surgery, avoiding more invasive procedures such as PK or DALK.

Financial Disclosure:

NONE