Therapeutic PRK based on total corneal wavefront improves vision in irregular corneas
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VIENNA — Therapeutic PRK guided by the CSO MS-39 device for anterior segment analysis allows for customized, tissue-sparing treatment of irregular corneas.
In combination with other treatments, it can improve vision in patients with keratoconus, according to Emilio Torres-Netto, MD, PhD, speaking at the European Society of Cataract and Refractive Surgeons meeting.
“Until now, we had the anterior corneal wavefront based on topography or the total wavefront measuring the whole eye, and all our laser treatments were based on the anterior corneal surface,” he said. “With the MS-39, we are now able to measure the total corneal wavefront that takes into account not only the anterior but also the posterior corneal surface.”
By taking into account the compensatory effects between anterior and posterior corneal surfaces, total corneal wavefront-based treatment results in better image quality and saves tissue.
“In the same way we approach toric IOL power calculation, including the astigmatism of the posterior cornea,” Torres-Netto said.
However, he said that therapeutic PRK can provide only a limited amount of correction because only a limited amount of tissue can be removed from the cornea to prevent a detrimental biomechanical impact. Therefore, PRK is usually combined with other approaches.
“Before or after PRK, we can use phakic IOLs, corneal rings or femto [corneal allogenic intrastromal ring segments], and customized cross-linking. That’s the base for improving the irregularity, and then use the laser as fine-tuning for further improvement of vision,” Torres-Netto said.
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Torres-Netto E. Total corneal wavefront transPRK using MS-39. Presented at: European Society of Cataract and Refractive Surgeons meeting; September 8-12, 2023; Vienna.
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