Predicting Transepithelial Phototherapeutic Keratectomy Outcomes Using Fourier Domain Optical Coherence Tomography

被引:15
作者
Cleary, Catherine [1 ,2 ]
Li, Yan [1 ,2 ]
Tang, Maolong [1 ,2 ]
El Gendy, Nehal M. Samy [1 ,2 ,3 ]
Huang, David [1 ,2 ]
机构
[1] Oregon Hlth & Sci Univ, Casey Eye Inst, Ctr Ophthalm Opt & Lasers, Portland, OR 97239 USA
[2] Univ So Calif, Keck Sch Med, Dept Ophthalmol, Doheny Eye Inst, Los Angeles, CA 90033 USA
[3] Cairo Univ, Dept Ophthalmol, Kaser Al Aini Sch Med, Cairo, Egypt
关键词
optical coherence tomography; Fourier domain optical coherence tomography; PTK; image-guided surgery; corneal opacity; corneal dystrophy; corneal scar; LASIK 3-DIMENSIONAL DISPLAY; STEEP CENTRAL ISLANDS; EXCIMER-LASER; EPITHELIAL THICKNESS; CORNEAL DYSTROPHIES; REFRACTIVE CHANGES; ARTEMIS;
D O I
10.1097/ICO.0000000000000050
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose:The aim of this study was to use Fourier domain optical coherence tomography to predict transepithelial phototherapeutic keratectomy outcomes.Methods:This is a prospective case series. Subjects with anterior stromal corneal opacities underwent an excimer laser phototherapeutic keratectomy (PTK) combined with a photorefractive keratectomy using the VISX S4 excimer laser (AMO, Inc, Santa Ana, CA). Preoperative and postoperative Fourier domain optical coherence tomography images were used to develop a simulation algorithm to predict treatment outcomes. Main outcome measures included preoperative and postoperative uncorrected distance visual acuities and corrected distance visual acuity.Results:Nine eyes of 8 patients were treated. The nominal ablation depth was 75 to 177 m centrally and 62 to 185 m peripherally. Measured PTK ablation depths were 20% higher centrally and 26% higher peripherally, compared with those for laser settings. Postoperatively, the mean uncorrected distance visual acuity was 20/41 (range, 20/25-20/80) compared with 20/103 (range, 20/60-20/400) preoperatively. The mean corrected distance visual acuity was 20/29 (range, 20/15-20/60) compared with 20/45 (range, 20/30-20/80) preoperatively. The MRSE was +1.38 2.37 diopters (D) compared with -2.59 +/- 2.83 D (mean +/- SD). The mean astigmatism magnitude was 1.14 +/- 0.83 D compared with 1.40 +/- 1.18 D preoperatively. Postoperative MRSE correlated strongly with ablation settings, central and peripheral epithelial thickness (r = 0.99, P < 0.00001). Central islands remained difficult to predict and limited visual outcomes in some cases.Conclusions:Optical coherence tomography measurements of opacity depth and 3-dimensional ablation simulation provide valuable guidance in PTK planning. Post-PTK refraction may be predicted with a regression formula that uses epithelial thickness measurements obtained by optical coherence tomography. The laser ablation rates described in this study apply only to the VISX laser.
引用
收藏
页码:280 / 287
页数:8
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