Treatments of regression after myopic refractive surgery by use of transepithelial, topography, and epithelial thickness map: guided ablation

Session Details

Session Title: LASIK I

Session Date/Time: Sunday 23/09/2018 | 14:00-16:00

Paper Time: 14:46

Venue: Room A3, Podium 2

First Author: : F.Stojanovic NORWAY

Co Author(s): :    W. Zhou                    

Abstract Details

Purpose:

By use of transepithelial, topography- and epithelial thickness map- guided ablation; input data are aimed to address secondary corneal irregularities and epithelial remodeling after previous myopic laser refractive surgery. Current study evaluates the clinical outcomes with such approach.

Setting:

A non-comparative, retrospective consecutive case series treated at SynsLaser clinics in Tromsø and Oslo, Norway

Methods:

Sixty eyes of 43 patients with regression after laser refractive surgery for myopia and compound myopic astigmatism were treated by transepithelial, topography- and epithelial thickness map- guided ablation. Stromal ablation profile was compiled by use of data from Scheimpflug corneal topography, while the epithelial ablation depth was programed by use of corneal epithelial mapping obtained by corneal optical coherence tomography (OCT). Changes in uncorrected distance visual acuity (UDVA), manifest refraction and corrected distance visual acuity (CDVA), topographic anterior corneal irregularity index (IRI), asphericity, odd-order and even-order higher order aberrations (HOAs) as well as epithelial thickness profile were evaluated.

Results:

The mean follow-up time after retreatment was 18.5 ±12.4 months. The mean spherical equivalent (SE) was reduced from -1.12 diopters (D) ±0.58 (SD) to -0.27D±0.35. Safety and efficacy indexes were 1.09 and 0.87 respectively. At their last follow-up visit 95% and 63% had a UDVA of 20/40 and 20/20 or better. IRI and odd-order HOAs both improved significantly (p<0.003). Even-order HOAs and total corneal asphericity improved insignificantly (p=0.12 and 0.45). Epithelial thickness profile showed significant smoothening between the central 2mm and 2-5mm with an average decrease in difference of 3.75 µm (p<0.001).

Conclusions:

Use of transepithelial, topography- and epithelial thickness map- guided custom ablation in patients who previously underwent myopic refractive surgery is safe and effective method in treatment of regression and induction of HOAs.

Financial Disclosure:

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