Transepithelial, Topography-guided Ablation in the Treatment of Visual Disturbances in LASIK Flap or Interface Complications

Abstract

Corneal regularization and removal of the underlying flap or interface pathology by cTEN ablation appears to be an effective treatment for LASIK flap or interface complications associated with visually disturbing irregular astigmatism and light scattering in cases with sufficient residual stromal thickness.

Topography-guided transepithelial photorefractive keratectomy for irregular astigmatism using a 213 nm solid-state laser

“…This may have advantages for transepithelial PRK, in which laser treatment commences at the epithelial surface without preliminary drying. 9 We sought to extend the exploratory use of the platform by Anderson et al 8 using transepithelial topographic PRK to treat irregular astigmatism resulting from previous corneal transplantation or previous refractive surgery. One-year results are described.…”

Comparison of Corneal Epithelial and Stromal Thickness Distributions between Eyes with Keratoconus and Healthy Eyes with Corneal Astigmatism ≥2.0 D

“…Precise programming of the epithelial thickness into the ablation plan of transepithelial topography-guided treatments, instead of use of an anticipated value, will decrease the amount of stromal tissue removed by the ablation when the epithelium is thinner than anticipated, or it will guarantee that all of the planned stromal tissue is removed if the epithelium is thicker than anticipated [19], [21]. The data provided by the epithelial thickness mapping may also increase the safety and predictability of retreatments for myopic regression occurring after excimer laser surgery by providing information regarding whether the regression occurred due to the epithelial hyperplasia or corneal biomechanical changes [4], [8].…”

Comparison of femtosecond and excimer laser platforms available for corneal refractive surgery

“…In cases of an increased angle kappa, topography-guided ablations centered on the corneal vertex have been shown to better approximate the visual axis than wavefront-guided ablations centered on the pupil [80]. Perhaps the greatest value of topography-guided ablation, however, is in the treatment of highly aberrated corneas, where it has been shown to successfully treat postrefractive surgery complications such as ectasia, decentered ablation, and small optical zones [81,82].…”