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Wavefront-guided surface ablation effective in eyes with high coma, trefoil
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SAN DIEGO — Wavefront-guided surface ablation is a safe and effective way to improve vision in eyes with significant coma or trefoil, according to a surgeon speaking here.
David Hardten, MD, presented the short-term results of a retrospective study of the procedure at the American Society of Cataract and Refractive Surgery meeting.
Dr. Hardten and colleagues looked at 121 eyes of 71 patients who had either high coma or trefoil associated with atypical topography. Mean preoperative spherical equivalent was 3.5 D with mean astigmatism of 0.7 D. Mean coma and trefoil were 0.3 µm and 0.17 µm, respectively, he said.
Surgeons used a VISX STAR S4 excimer laser (Advanced Medical Optics) to perform PRK or alcohol-assisted LASEK with a mean depth of treatment of 60 µm. No microkeratome cases were included in the study, he said.
A total of 110 cases were available for follow-up at 3 or more months postop. Mean spherical equivalent was reduced to 0.02 D with 0.3 D of astigmatism. Uncorrected visual acuity was 20/20 or better in 80% of patients and 20/40 or better in all patients, Dr. Hardten said.
Preliminary 1-year data indicated that 95% of patients were 20/25 or better, he said.
"In this group of patients where the surgeon chose PRK over LASIK because of atypical findings on the cornea, the results are quite good," he said. "But they're not as good as in LASIK in normal eyes, so these patients all received special counseling about the fact that they weren't going to be as accurate because there was something else unusual about their eyes."