One-step transepithelial topography-guided ablation in the treatment of myopic astigmatism

PLoS One. 2013 Jun 17;8(6):e66618. doi: 10.1371/journal.pone.0066618. Print 2013.

Abstract

Purpose: To evaluate one-step topography-guided transepithelial ablation in the treatment of low to moderate myopic astigmatism using a 1KHz excimer laser.

Methods: Retrospective study of 117 consecutive eyes available for evaluation 12 months after surgery. Pre- and post-operative visual and refractive data as well as post-operative pain and haze were analyzed. A novel technique integrating custom refractive- and epithelial- ablation in a single uninterrupted procedure was used.

Results: The mean pre-operative spherical equivalent (SE) and the mean cylinder were: -3.22 diopters (D) ±1.54 (SD) (range -0.63 to -7.25 D) and -0.77 D ±0.65 (range 0 to -4.50 D), respectively. At 12 months after surgery: no eyes lost ≥2 lines of corrected distant visual acuity (CDVA). Safety and efficacy indexes were 1.27 and 1.09, respectively. Uncorrected distant visual acuity (UDVA) was ≥20/20 in 96.6% of the eyes. Manifest refraction spherical equivalent was within ±0.5 D of the desired refraction in 93.2% of the eyes. Average root mean square (RMS) wavefront error measured at central 6 mm, increased from 0.38 pre-operatively to 0.47 µm post-operatively. Refractive stability was achieved and sustained 1 month after surgery. No visually significant haze was registered during the observation period. Post-operative pain was reported in 4.5% of patients.

Conclusions: One-step transepithelial topography-guided treatment for low to moderate myopia and astigmatism performed with a 1 KHz laser, provided safe, effective, predictable and stable results with low pain and no visually significant haze.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Astigmatism / complications
  • Astigmatism / physiopathology
  • Astigmatism / surgery*
  • Corneal Surgery, Laser / methods*
  • Corneal Topography* / adverse effects
  • Corneal Topography* / standards
  • Female
  • Humans
  • Male
  • Myopia / complications
  • Myopia / physiopathology
  • Myopia / surgery*
  • Retrospective Studies

Grants and funding

This work was supported by SynsLaser Kirurgi AS, Tromsø, Norway and Norges forskningsråd, Oslo, Norway. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.