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Topography-guided laser shows promise for highly aberrated corneas
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Topography-guided ablation appears to be an effective alternative for patients who are unable to have wavefront-guided treatment, according to Simon Holland, MD, FRCSC.
 Simon Holland |
"The thing about topographically guided treatment is how relevant is it going to be to the comprehensive ophthalmologist? Even to refractive surgeons, what is its place going to be? It's in its early days, as it's not U.S. Food and Drug Administration-approved yet," Dr. Holland said at the OSN New York symposium.
He outlined results from a study that he performed with colleagues, looking at 121 cases at 1 year follow-up with the WaveLight Allegretto Wave topolyzer. The study was published in the April edition of Journal of Refractive Surgery.
They found improvement or resolution of symptoms in 79% to 83% in the groups studied with decentered ablation, small optic zone and keratoconus. Symptoms that did not resolve included residual or induced refractive error and regression, Dr. Holland said.
Topography-guided treatment indications include highly symptomatic patients with irregular astigmatism, decentered ablations after PRK and LASIK, and keratoconus, he said.
However, topography-based treatment also has theoretical limitations, Dr. Holland said. Whereas wavefront captures physiology, topography is anatomical and measures only the anterior corneal surface, while aberrations can also occur in the back surface and lens, he said.