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Micro-radial and arcuate incisions for the correction of residual pseudophakic myopic astigmatism

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First Author: F.Bucci USA

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Abstract Details

Purpose:

To evaluate the visual and refractive outcomes with the combination of micro-radial and arcuate incisions, micro-radial incisions alone, or AK incisions alone performed in pseudophakic eyes for the management of residual myopic astigmatism, mypoia alone, or astigmatism alone.

Setting:

Bucci Laser Vision Institute Wilkes-Barre, PA USA

Methods:

1,042 eyes having undergone micro-RK/AK (n=532), micro-RK alone(n=110), or AK alone(n=400) for the correction of residual pseudophakic refractive errors were retrospectively reviewed to evaluate the postoperative uncorrected visual acuities and refractive outcomes. The Lindstrom “mini-RK” nomogram was used to perform 1, 2, or 4 micro-radial incisions when myopia was present (n=642) with optical zones of 5.00, 5.25, or 5.50 mm. Micro-RK incisions were never greater in length than 2.75mm. Myopia was corrected from a range of -0.25D to -1.50D and astigmatism was corrected up to 2.50D. Cases were performed between April, 1998 and January, 2020.

Results:

The mean preop myopic spherical equivalent and preop refractive astigmatism were -0.59D(.46) and 1.03D(.52) respectively. The mean postop spherical equivalent and postop refractive astigmatism were reduced to -0.07D(.40) and 0.24D(.47) respectively. The uncorrected Snellen visual acuity improved from 20/38.6 to 20/23.8. 51.7% of eyes received 2 micro-RK incisions, 21.7% received 1 incision, & 26.6% received 4 incisions. 70.2% percent of eyes had an optical zone of 5.50mm, 25.7% had an optical zone of 5.25mm, and 4.0% had an optical zone of 5.00mm. These short micro-radial incisions produced no visual fluctuations, hyperopic shifts, or induced dry eye.

Conclusions:

1) Micro-RK/AK is a safe and effective treatment for treating residual myopic astigmatism in pseudophakic eyes especially for those demanding patients who have received premium IOLs 2) Hyperopic shifts and/or daily fluctuations in vision as observed in traditional RK patients was not observed in these patients receiving very short micro-radial incisions. 3) Micro-RK/AK leaves the central 5mm of the cornea untouched, does not create a neurotrophic cornea or epithelial modulation as observed with LASIK and PRK. 4) Micro-RK/AK provides a rapid improvement in vision with minimal ocular discomfort.

Financial Disclosure:

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