Topography-guided photorefractive keratectomy for correction of irregular astigmatism following penetrating keratoplasty

Session Details

Session Title: Photoablation

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

Paper Time: 15:27

Venue: Hall C2

First Author: : J.Tan SINGAPORE

Co Author(s): :    S. Holland   D. Lin   S. Mosquera              

Abstract Details

Purpose:

To evaluate early results of topography-guided Photorefractive Keratectomy (TGPRK) for correction of irregular astigmatism following penetrating keratoplasty (PK) with the Schwind Amaris Excimer Laser.

Setting:

Pacific Laser Eye Centre, Vancouver, BC, Canada

Methods:

Retrospective, non-randomized, consecutive series of eyes with irregular astigmatism following PK with contact lens intolerance underwent trans-epithelial TGPRK with the Schwind Amaris Excimer Laser. Eyes with at least 12 months of follow-up were included. The efficacy and safety of the treatment were analyzed: pre-operative and post-operative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction (MR), topographic cylinder and the number of Snellen lines gained or lost. Any complications were recorded.

Results:

19 of 38 eyes treated had sufficient data at 12 months for analysis. 5 of 19 eyes (26%) showed UCVA ≥20/40 post-operatively compared with none pre-operatively. 9 eyes (47%) had improved BCVA of one line or more, and 6 eyes (32%) gained two or more lines. 2 eyes (11%) lost two or more lines.The mean pre-operative topographic cylinder was 5.17±2.31D. The mean reduction in astigmatism (RIA) was 2.66±2.24D. Mean spherical equivalent improved from -1.96±3.37D to -0.95±2.28D. No patient showed regression up to 12 months post-operatively. There were no eyes with visually significant haze and no infection post-operatively. 5 had delayed epithelial healing.

Conclusions:

Early results of trans-epithelial TGPRK with the Schwind Amaris Excimer Laser showed improved efficacy and safety for the treatment of irregular astigmatism following PK. Almost half had improved BCVA. This study demonstrates an alternative treatment for highly symptomatic patients with irregular astigmatism following penetrating keratoplasty with contact lens intolerance. Advantages of the Schwind Amaris include high speed, multi-directional tracking and torsion control.

Financial Disclosure:

NONE