Posters

Topography-guided photorefractive keratectomy for irregular astigmatism following penetrating keratoplasty (PK): a useful option?

Poster Details

First Author: M.Al Obthani CANADA

Co Author(s):    S. Holland   D. Lin   S. Arba Mosquera   J. Tan           

Abstract Details

Purpose:

Evaluation of efficacy and safety of topography-guided photorefractive keratectomy (TG PRK) for irregular astigmatism following penetrating keratoplasty (PK). High and irregular astigmatism frequent after keratoplasty. Astigmatic keratotomy and wedge resections are accepted alternatives to contact lens intolerant patients. We aimed to determine results of an upgraded laser beam profile TGPRK for post-keratoplasty astigmatism. TGPRK may be less invasive with faster return of vision

Setting:

Laser Refractive Clinic

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 SmartSurfACE Excimer Laser.. Eyes with a minimum 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:

41 eyes completed 12 months follow-up for analysis. 15/41(36.6%) had UCVA 20/40 or better while none preoperatively. 18(44%) had CDVA improved, 13(32%) gained 2 lines or more, 6(15%) lost 2 lines or more. Reduction in astigmatism (RIA) was 2.43±2.32D. Mean spherical equivalent improved from -3.14±3.99D to -1.44±2.21D. No patient showed regression up to 12 months post-operatively. Five eyes had delayed epithelial healing without long term sequelae.

Conclusions:

One year results of trans-epithelial TG-PRK (Schwind Amaris Excimer Laser SmartSurface) showed satisfactory efficacy and safety for treatment of irregular astigmatism following corneal transplantation . 44% had improved CDVA and 32% gained ≥2 lines. More than one third achieved ≥20/40 UCDA postoperatively but none before surgery. Mean reduction in astigmatism was 2.43D. The technique appears to be a good alternative treatment for highly symptomatic contact lens intolerant patients with irregular astigmatism following penetrating keratoplasty

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, receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented