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

Session Details

Session Title: Keratoconus & Secondary Ectasia

Session Date/Time: Sunday 15/09/2019 | 08:00-10:00

Paper Time: 09:33

Venue: Free Paper Forum: Podium 2

First Author: : J.Tan CANADA

Co Author(s): :    D. Lin   S. Holland   A. Covello   S. Arba Mosquera   V. Shwetabh   M. Al Obthani              

Abstract Details

Purpose:

Post-keratoplasty eyes frequently have high and irregular astigmatism may be difficult to correct with rigid contact lenses possibly needing further surgery such as wedge resection. We aimed to evaluate topography-guided Photorefractive Keratectomy (TG-PRK) for correction of irregular astigmatism following penetrating keratoplasty (PK) using Schwind Amaris

Setting:

Laser Eye Centre

Methods:

Retrospective, non-randomized, consecutive series of contact lens intolerant eyes with irregular astigmatism following PK that underwent trans-epithelial TG-PRK with the Schwind Amaris 1050 SmartSurfACE Excimer Laser. Eyes with at least 12 months of follow-up were included. Data collected included pre-operative and post-operative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction (MR), topographic cylinder and the number of Snellen lines gained or lost. Any complications were recorded.

Results:

45 eyes had sufficient data at 12 months for analysis. 16/45 eyes (36%) showed UDVA ≥20/40 post-operatively with none pre-operatively. 21 eyes (46%) had improved CDVA with 15 eyes (33%) gained ≥2 lines. 5 eyes (11%) lost ≥2 lines. Mean astigmatism improved from 4.94±2.35D to 2.58±2.12D. Mean spherical equivalent improved from -3.00±3.93D to -1.49±2.18D. Two eyes had visually significant haze and 3 with irregular astigmatism and no infection post-operatively. Five eyes had delayed epithelial healing beyond one week without long term sequelae. No patient showed regression up to 12 months post-operatively.

Conclusions:

Trans-epithelial TG-PRK showed satisfactory efficacy and safety for treatment of irregular astigmatism following corneal transplantation. One third achieved ≥20/40 UDVA postoperatively but none before surgery. TG-PRK may be a good alternative to astigmatic keratotomy and wedge resection for contact lens intolerant post keratoplasty patients.

Financial Disclosure:

is employed by a for profit company with an interest in the subject of the presentation, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented