Customized photoastigmatic refractive keratectomy using combined topographic and refractive data for myopia and astigmatism in eyes with forme fruste and mild keratoconus

Alpins, Noel; Stamatelatos, George

doi:10.1016/j.jcrs.2006.12.014

Cited by 87 publications

(61 citation statements)

References 28 publications

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“…The emphasis between the two astigmatisms is decided by the individual surgeon. In two later clinical series, the treatment was set to leave 60% of the ORA corrected on the cornea and 40% in the refraction (Alpins & Stamatelatos 2007, 2008.…”

Section: Discussionmentioning

confidence: 99%

Combining refractive and topographic data in corneal refractive surgery for astigmatism

Næser¹

2011

Acta Ophthalmologica

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. Purpose: To provide a theoretical approach for combining refractive and topographic data in the planning of corneal laser refractive surgery for astigmatism. Methods: Refractive and topographic data for astigmatism were transformed to the corneal plane. Net astigmatisms were converted to polar values. An optimization process was performed with the use of differential calculus. Results: With this method, the magnitude of the corneal astigmatism is reduced or unaltered, while its orientation is maintained. The method identifies the reduction in corneal astigmatism, which will yield the largest reduction in refractive astigmatic magnitude. Conclusions: The advantage of the optimization method described in this article is a consistent reduction in corneal astigmatism towards sphericity. No new corneal astigmatism is carved on the cornea, and probably less tissue is ablated. The optimization method may also be used to combine refractive and topographic data for higher order aberrations with sinusoidal components. However, compared to the traditional purely refractive driven treatment, more refractive astigmatism will remain in the eye in most cases. A controlled clinical trial is necessary for comparing these two treatment modalities.

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Section: Discussionmentioning

confidence: 99%

Combining refractive and topographic data in corneal refractive surgery for astigmatism

Næser¹

2011

Acta Ophthalmologica

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“…Surface ablation is an alternative surface procedure which is commonly used in patients with abnormal corneal topography such as forme fruste keratoconus, as well as in thin corneas, and large pupils [5,6]. Postoperative pain and early visual rehabilitation are the challenges in these surface procedures.…”

Section: Introductionmentioning

confidence: 99%

Effect of Flap Removal in Myopic Epi-LASIK Surgery on Visual Rehabilitation and Postoperative Pain: A Prospective Intraindividual Study

Lee

Park

et al. 2010

Ophthalmologica

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Purpose: A prospective intraindividual study to evaluate the effect of flap removal in myopic epi-LASIK surgery on visual rehabilitation and postoperative pain. Methods: Ninety eyes of 45 patients were treated for myopia with epi-LASIK. In each patient, the epithelial flap was repositioned in one eye after epi-LASIK (group 1) while the flap was removed in the other (group 2). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE) refraction, postoperative pain and corneal haze were examined for 6 months after surgery in both groups. Results: Group 2 had a better UCVA at 4 days and BCVA at 1 week after surgery (p = 0.001, p = 0.043) than group 1. No significant differences were observed between the two groups in terms of UCVA, BCVA, or SE refraction at 1 week and 1, 2 and 6 months. Postoperative pain scores were similar for both groups. In group 2, severe pain (pain level ≧6) was relatively less than in group 1 at 2 h and 12 h after surgery. Corneal haze levels in both groups were not different. Conclusions: Epi-LASIK surgery with flap removal was found to significantly promote re-epithelialization and visual recovery during the early postoperative period. It was also found to be more predictable and less painful than epi-LASIK surgery.

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“…Excimer laser surgery in the form of topo-guided photorefractive keratectomy (T-PRK) has been also proposed for the regularization of anterior corneal shape, decreasing irregular astigmatism in order to improve visual outcomes. [4][5][6] The combination CXL and excimer laser enabled T-PRK is the new integrated emerging treatment for mild to moderate keratoconus. The goal of this combination is to treat keratoconic patients and offer them both stability and functional vision.…”

Section: 5005/jp-journals-10025-1035mentioning

confidence: 99%

“…The technique demonstrated promising results with the main drawback being that it is a tissue removal technique. [4][5][6] …”

Section: Tips From the Past-t-prk For Stable/forme Fruste Keratoconusmentioning

confidence: 99%

Update on Simultaneous Topo-guided Photorefractive Keratectomy Immediately Followed by Corneal Collagen Cross-linking for Treatment of Progressive Keratoconus

Kymionis¹,

Yoo²,

Kankariya³

et al. 2012

International Journal of Keratoconus and Ectatic Corneal Diseases

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Corneal collagen cross-linking (CXL) is a safe and effective technique for the management of corneal ecstatic disorders. It has been proven that CXL is effectual in stopping the progression of keratoconus quasi 'freezing' the cornea and in many cases avoiding corneal transplantation. Nevertheless, patients' basic problem, which is the deterioration of their vision due to irregular astigmatism, remains. CXL combined with topography-guided photorefractive keratectomy (PRK) has been developed in order to achieve an important goal. To offer patients stability of their disorder and at the same time to assist them in achieving a functional vision by improving topographic outcomes. This article discusses update on this new combination therapy in the form of topo-guided PRK immediately followed by CXL as one-step procedure for treatment of progressive keratoconus.

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Customized photoastigmatic refractive keratectomy using combined topographic and refractive data for myopia and astigmatism in eyes with forme fruste and mild keratoconus

Cited by 87 publications

References 28 publications

Combining refractive and topographic data in corneal refractive surgery for astigmatism

Combining refractive and topographic data in corneal refractive surgery for astigmatism

Effect of Flap Removal in Myopic Epi-LASIK Surgery on Visual Rehabilitation and Postoperative Pain: A Prospective Intraindividual Study

Update on Simultaneous Topo-guided Photorefractive Keratectomy Immediately Followed by Corneal Collagen Cross-linking for Treatment of Progressive Keratoconus

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