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Preliminary study shows wavefront treatment helps patients with keratoconus

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WASHINGTON — Wavefront-guided surface ablation may be appropriate for use in patients with significant coma and trefoil due to keratoconus, according to one surgeon.

Richard L. Lindstrom, MD, and colleagues evaluated the effect of wavefront-guided surface refractive surgery in 56 patients with high coma or trefoil due to keratoconus. He presented preliminary results of the study here at the American Society of Cataract and Refractive Surgery meeting.

Preoperatively, the average higher-order aberrations at a 6-mm optical zone were 0.37 µm. Coma was 0.23 to 0.09 µm. Trefoil was 0.12 µm to 0.08 µm. Average spherical equivalent was –3.15 D. Average astigmatism was 0.92 D. Mean physician adjustment to nomogram was –0.34 D, Dr. Lindstrom reported.

The preliminary results at 3 months postop showed that all patients had achieved 20/40 or better uncorrected visual acuity; 92% achieved 20/25 or better UCVA, and 80% achieved 20/20 or better UCVA. Average spherical equivalent was +0.09 D, he said.

Dr. Lindstrom said corneal ablation in keratoconus patients is a controversial topic. He said many surgeons would perform keratoplasty on patients with keratoconus who were at risk for ectasia.