Topography-based screening for previous laser in situ keratomileusis to correct myopia and hyperopia

Purpose: To develop a screening tool based on corneal topography to detect previous myopic and hyperopic laser in situ keratomileusis (LASIK). Methods: Clinical data from three private clinics were analyzed in a university setting. A total of 476 topographies (Orbscan II) were randomly selected (1 topography per patient): 338 from unoperated corneas, 81 from corneas that had LASIK to correct myopia, and 57 from corneas that had LASIK to correct hyperopia. The LASIK procedures were performed using a Technolas excimer laser (217C or 217Z) and a Hansatome microkeratome. The first set of algorithms (VESm and VESh) calculated the volume summation between the anterior corneal surface and the best-fit sphere in the central and mid-peripheral regions. The second set of algorithms (DCm and DCh) calculated the mean anterior tangential curvature difference between the central and mid-peripheral regions. Results: The features VESm and DCm for the screening of a myopic LASIK yield, respectively, sensitivity rates of 92.7% and 95.1% and specificity rates of 94.9% and 96.5%. The features VESh and DCh for the screening of a hyperopic LASIK gave sensitivity rates of 93.1% for both and specificity rates of 94.8% and 97.1%. The performance of those features was superior to clinical assessment using topography color maps. Conclusions: Criteria based on Orbscan II corneal topography are proposed for the detection of previous hyperopic and myopic LASIK performed with a Technolas excimer laser (version 217C or 217Z).