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CK shows better efficacy than hyperopic LASIK, speakers say
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NEW ORLEANS — Conductive keratoplasty may have found its niche as a remedy for LASIK overcorrection and undercorrection, according to several surgeons here at the International Society of Refractive Surgeons meeting.
Speakers at yesterday's Thermokeratoplasty and Non-Excimer Lasers session presented results with conductive keratoplasty (CK) and other new approaches to refractive surgery.
Most speakers on CK agreed its safety profile is comparable to LASIK, although concern was expressed regarding the percentage of patients who develop induced astigmatism postop. In general, the optimal number of spots should be around 12, surgeons said, although the procedure is approved for as many as 24 spots.
Michael Lawless, FRACO, noted the refractive effect of CK tends to stabilize at about 6 months. Marguerite McDonald, MD, reported similar findings. After 1 year follow-up in her patients, 51% of 390 eyes had uncorrected visual acuity (UCVA) of 20/20 or better, 75% had UCVA of 20/25 or better, and 91% had 20/40 or better.
James Rowsey, MD, said he is concerned by the regression his patients have experienced after laser thermokeratoplasty (LTK) surgery (mean 1.5 D). Dr. Rowsey has seen close to 50% regression, with poor predictability in astigmatism correction. As a result, he recommends surgeons avoid using any type of keratoplasty on keratoconus patients.
George Waring, MD, said diode thermokeratoplasty gives surgeons the ability to adjust the amount of energy administered more accurately than Ho:YAG laser systems can. This gives surgeons more predictable burns and more flexibility in spot placement.
Dr. Waring said older patients showed less regression than younger patients with the procedure. "DTK is an evolution in thermokeratoplasty," he said, "but we need to work on the variables."
Trials being conducted outside the United States on the IntraLase indicate patients have experienced no loss of best corrected visual acuity, although these results are preliminary, said Ron Kurtz, MD.