Posters

Comparison of early outcomes of topography-guided photo-refractive keratectomy for ectasia with 2 refractive lasers

Poster Details

First Author: S.Holland CANADA

Co Author(s):    D. Lin   K. Termote                 

Abstract Details

Purpose:

To evaluate early results of topography-guided photorefractive keratectomy (TG-PRK) with simultaneous collagen cross-linking (CXL) between Wavelight Allegretto (WA) and Schwind Amaris (SA) refractive lasers for Ectasia post - Laser-Assisted in situ Keratomileusis (LASIK)

Setting:

Pacific Laser Eye Centre, Vancouver, Canada

Methods:

Consecutive series, performed sequentually with 53 eyes underwent TG-PRK CXL using WA and then 13 using SA. Trans epithelial PRK. Both groups were performed with the assistance of separate custom Topographical Neutralization Techniques (TNT). Cross linking with modified Dresden protocol with residual stromal depth of 300 um Pre and post-operative assessment of symptoms, uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), manifest refraction (MR) predictability, and safety were analyzed at 1, 3, and 6 months.

Results:

35/53 cases WA and 7/13 cases SA had sufficient data at 3 months follow-up for analysis. 19/35 (54%) of WA and 4/7 (57%) of SA had ≥20/40 UCVA. 32 (91%) of WA and 7 (100%) of SA had ≥20/40 BSCVA. (p <0.05) 23 (66%) of WA and 4 (57%) of SA had BSCVA improved. 10 (29%) of WA and 3 (43%) of SA had BSCVA improved ≥2 lines. Mean astigmatism reduction was 2.47±1.97D for WA and 1.86±1.74D for SA. complications included delayed epithelial healing beyond one week in three cases and haze sufficient to reduce vision in two. All but 3 in AW and 2 in SA had improved symptoms, and all would have the procedure again

Conclusions:

Post Lasik Ectasia treated with TG PRK and crosslinking showed satisfactory early results with two lasers. Reasonable efficacy and good safely achieved with a half of all paients gaining 2 lines of BSCVA with few side effects. Comparison between the 2 goups did not show any significant differences but this may be due early results and small numbers SA has advantage of excellent tracking, cyclotorsion control and multiple customizable options while WA has established nomograms with studies showing efficacy and safety

Financial Disclosure:

One or more of the authors receives consulting fees, retainer, or contract payments from a competing company