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Six ‘golden steps’ to customized ablation
ORLANDO, Fla. — Perfect customized ablation depends upon six steps, all of which must work together to produce the right outcome, said Francesco Carones, MD, here during the Lans Lecture at the International Society of Refractive Surgery meeting.
The six steps, he said, are measurement of aberration, integration of data into an algorithm, registration of the data onto the cornea, laser delivery and tracking, online ablation feedback and adjustment, and wound healing control.
The first four steps are technical issues, Dr. Carones said, and will depend upon the laser platform the surgeon chooses. The last two steps involve “real cornea,” he said.
Dr. Carones described an intraoperative corneal topographer (BioShape) he is investigating that measures the corneal surface shape in three dimensions. “It's very useful for visualizing small surface irregularities and may help give us information on the corneal healing response,” Dr. Carones said.
With higher order aberrations, surgeons must start creating and evaluating online feedback, he added.