Topography-guided ablation may offer benefits after laser vision correction
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Key takeaways:
- Topography-guided ablation can improve visual outcomes and quality after laser vision correction.
- Advantages of the procedure include the ability to treat both higher- and lower-order aberrations.
SAN DIEGO — Topography-guided ablation can improve visual outcomes and visual quality in patients who previously underwent laser vision correction, according to a speaker here.
“No other technology can do what topography-guided ablation can do,” Roberto Pineda, MD, said during Refractive Day at the American Society of Cataract and Refractive Surgery meeting.
The advantages of topography-guided ablation (TGA) include the ability to treat both lower-order aberrations and corneal-based higher-order aberrations, Pineda said. TGA can also address peripheral corneal abnormalities and is not susceptible to errors created by pupil centroid shift. Additionally, TGA has been shown to minimize the amount of stromal tissue ablation, and TGA centration is based on the corneal apex instead of the pupil center, which minimizes issues with angle kappa.
When considering treatment with TGA, it is important to remember that with increased higher-order aberrations, there is typically a larger discrepancy between manifest and topographic cylinder, Pineda said. In addition, ocular residual astigmatism can be significant in magnitude and axis between manifest astigmatism and TGA-recommended astigmatism.
Surgeons also need to weigh the ongoing debate regarding optimal method of prescription planning as well as the lack of published literature regarding TGA in laser vision correction enhancements.
There are several approaches for presurgical planning for TGA but no standardized method, Pineda said, particularly for post-laser vision correction. Going forward, data acquisition and staff training will both be critical.
Editor's note: Concerns about this article were voiced in a letter to the editor, which can be read here.
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Pineda R. Topo-guided enhancement after LVC: When do we use this technology? Presented at: American Society of Cataract and Refractive Surgery meeting; May 5-8, 2023; San Diego.
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