Posters

Wavefront-guided photorefractive keratectomy using a high-resolution aberrometer to treat irregular astigmatism after pseudomona infection

Poster Details

First Author: J.Campello Lluch SPAIN

Co Author(s):    R. Perez-Camprodi                    

Abstract Details

Purpose:

To report a very successful visual, refractive and aberrometric outcome obtained with the application of a customized photorefractive keratectomy (PRK) treatment in an irregular cornea. This moderate topographic irregularity was the consequence of a pseudomona aeruginosa infection that led to a paracentral and dense leucoma and a secondary suboptimal best corrected visual acuity (VA).

Setting:

Centro Oftalmológico de Elche (Alicante. Spain). Oftalmar. Vithas Hospital Internacional Medimar (Alicante. Spain)

Methods:

A 26-year-old woman attended to our clinic complaining of diminished vision in her left eye. Subjective refraction was -1 -1.50 x 155º with a VA of 20/40. Preoperative topography showed a severe flattening that involved the whole nasal cornea (Figure 1). The slit-lamp examination revealed a paracentral leucoma (Figure 2) characterized by means of the Scheimpflug camera (Figure 3). Corneal comatic aberration was 0.94 microns (µm) for a 5-mm pupil diameter. A wavefront-guided PRK with the ViSX S4 laser platform calculated with the iDesign G3000 aberrometer was proposed to compensate the refractive error and to minimize corneal aberrations (Figure 4).

Results:

Distance uncorrected VA improved from a preoperative value of 20/100 to a postoperative value of 20/20. Postoperative refractive status was emmetropia. The anterior curvature asymmetry index changed from 0.37 diopters (D) preoperatively to -0.15 D postoperatively. The elevation topographical map showed a change in the value of the corneal anterior asphericity (Q-value) from -0.38 to -0.22 after the surgery (Figure 5) and corneal coma decreased from 0.94 µm to 0.34 µm for a 5-mm pupil diameter (Figure 6).

Conclusions:

A wavefront-guided customized PRK with the ViSX S4 platform and the IDesign aberrometer seems to be an excellent option for the visual, refractive and anatomic rehabilitation of corneas with moderate irregularities secondary to pseudomona infection, diminishing the density of leucomas, minimizing the level of higher order aberrations and providing accurate visual results and predictability in the refractive programmed outcome.

Financial Disclosure:

None