Corneal wavefront-guided photorefractive keratectomy in patients with irregular corneas after corneal refractive surgery

被引:15
作者
Alio, Jorge L. [1 ,2 ]
Pinero, David P. [1 ,3 ]
Belen Plaza, Ana [1 ]
机构
[1] Univ Miguel Hernandez, Vissum Inst Oftalmol Alicante, Alicante, Spain
[2] Univ Miguel Hernandez, Div Ophthalmol, Alicante, Spain
[3] Univ Alicante, Dept Opt, Alicante, Spain
关键词
D O I
10.1016/j.jcrs.2008.06.025
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
PURPOSE: To evaluate the corrective potential of corneal wavefront-guided photorefractive keratectomy (PRK) in patients with high levels of corneal aberrations and symptoms after previous corneal refractive surgery. SETTING: Vissum-Instituto de Oftalmologico de Alicante, Alicante, Spain. METHODS: This study comprised 25 eyes (20 patients) that had 1 or more previous unsuccessful keratorefractive procedure. All eyes had PRK retreatment using the Esiris excimer laser and ORK-CAM software for customized ablation design. All eyes had a high preoperative level of corneal higher-order aberrations (HOAs) (coma-like or spherical-like root mean square [RMS] > 0.5 mu m). Changes in refractive outcomes, subjective symptoms, and corneal aberrometry were evaluated during a 6-month follow-up. RESULTS: Uncorrected visual acuity improved significantly from preoperatively (mean 0.48) to 6 months after retreatment (mean 0.75) (P <.01). The mean best spectacle-corrected visual acuity (BSCVA) also improved significantly, from 0.78 to 0.90, respectively (P <.01). Forty-four percent of patients gained 1 or more lines of BSCVA. The reduction in cylinder at 6 months was statistically significant (P = .01). Corneal aberrometry at 6 months showed a statistically significant reduction in total (P = .01), spherical-like (P <.01), coma-like (P = .02), and primary coma (P <.01) RMS. At 6 months, 72% of patients had low or no perception of halos and all reported no glare. CONCLUSION: Corneal wavefront-guided PRK enhancement with the ORK-CAM system minimized corneal HOAs in eyes with previous unsuccessful keratorefractive surgery.
引用
收藏
页码:1727 / 1735
页数:9
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