Posters

Role of PTK in tuning the refractive outcome of cataract surgery in patients with map-dot-fingerprint epithelial dystrophy of the cornea (MDF)

Poster Details

First Author: M.Ghali GERMANY

Co Author(s):                        

Abstract Details

Purpose:

Patients with corneal map-dot-fingerprint dystrophy suffer typically from recurrent corneal erosion, unstable disturbed vision, or both. Refractive outcome after Cataract surgery has been since long time a challenge for refractive surgeons. This retrospective study aimed to evaluate the effectiveness of photo-therapeutic Keratectomy (PTK) in improving the refractive outcome of further Cataract surgery in eyes with Cataract accompanied with Map-Dot-Fingerprint dystrophy.

Setting:

Eye clinic and laser center with Patients N=8 (11Eyes) in Hamburg, Germany (Augenklinik und Laserzentrum am Rothenbaum Prof. Dr. M.Boehnke / PD Dr.L.Wagenfeld), with mean Age 75 ± 5 years. Patients were treated in the period from 2015 to 2018. Data were analyzed retrospectively.

Methods:

Preoperative examinations included best corrected visual acuity (BCVA LogMAR), Spherical equivalent (SE), and IOL Power calculation (IOL Master 500 Zeiss). PTK was performed on 11 eyes with Schwind AMARIS 1050 platform. The mean follow-up was > 6 weeks ± 2 weeks post-PTK, with a maximum of 14 weeks.  BCVAA, SE, Mean Keratometric power (K-Mean) and IOL power calculation were repeated in follow up.  Refraction target was settled with mean -1.04 ± 0.75 Dp. (Emmetropie to max. -2.0 D). The IOL power was selected from post-PTK measurements.  Phacoemulsification and IOL Implantation (Basis monofokal IOL of 1stQ) went uneventful in all patients.

Results:

Variations BCVA, SE and IOL Measurement (pre and post -PTK) were analyzed retrospectively. The BCVA increased from 0.5 ± 0.2 preoperatively (pre-PTK) to 0.6 ± 0.2 post-PTK and further improving to 0.9 ± 0.1 post-Cataract. The SE post-Cataract was -1.16 ± 0.75 D (SD=0.02) from Mean refraction target. The K-Mean increased from 43.73D pre-PTK ± 2D to 44.29D ± 3D (SD=0.39). The IOL power calculation decreased from 22.13 ±6.0 D pre-PTK to post-PTK 21.04 ± 5.0 D (SD=0.77). Myopic shift from 0.75 to 1.0 D could have been expected, if PTK was not done prior to Cataract extraction.

Conclusions:

In view of the available evidence, we want to raise the awareness of those managing patients with MDF and Cataract that, in order to achieve better visual acuity and further better refractive outcome, PTK treatments are expected to be necessary prior to IOL-Measurement as preparation of Cataract extraction

Financial Disclosure:

None