Posters

Location of tomographical peaks can help predict ectasia development after refractive surgery

Poster Details

First Author: D.Masarwa ISRAEL

Co Author(s):    D. Masarwa   I. Kaiserman                 

Abstract Details

Purpose:

Corneal ectasia is the most dreaded complication of refractive surgery. Previous studies have reported several risk factors that may increase ectasia risk such as: young age, high myopia, low residual stromal bed thickness (RSB), low preoperative corneal thickness, and abnormal topography. Recently the percent of tissue altered (PTA) was found to be strongly associated with the development of ectasia in eyes with normal topography. We aim to determine other risk factors associated with ectasia development following refractive surgery.

Setting:

Care-Vision Laser Centers, Israel.

Methods:

In a retrospective study we included all patients who underwent refractive surgery between 2011 and 2018 at Care-Vision Laser Centers, Israel, and developed ectasia. For each ectasia case, 3-4 controls were selected that were operated on the same day by the same surgeon and had the same type of surgery. Demographic and preoperative data were collected. Including age, gender, PTA, RSB, Randleman criteria score (RCS), spherical equivalent, astigmatism, ablation depth (AD) and the diameter of the area of peaks location (DPL). Multivariate analysis was performed to evaluate the inter-dependence of the variables.

Results:

The study included 19 ectasia and 58 matched control eyes. Preoperatively the ectasia group was older than the control group (p = 0.033). There was no significant differences between the groups in their PTA (p =0.67); RSB (p =0.71); Randleman criteria score (p =0.21); ablation depth (p= 0.71); spherical equivalent (p =0.94). The DPL was significantly tighter in the ectasia group (2.61 ±1.21mm vs. 3.16±0.63mm, p = 0.02) and astigmatism was higher in the ectasia group (p = 0.009). Multiple logistic regression found the DPL to be more significant than PTA, age, RCS, and AD.

Conclusions:

While PTA, RSB, ablation depth, spherical equivalent and Randleman criteria were not significantly different between patients that developed ectasia and controls, a tighter colocalization of tomographical peaks may be an additional helpful predictor for the risk of developing ectasia after refractive surgery.

Financial Disclosure:

None