Simultaneous aspheric wavefront-guided transepithelial photorefractive keratectomy and phototherapeutic keratectomy to correct aberrations and refractive errors after corneal surgery.

To evaluate the results of combined aspheric wavefront-guided transepithelial excimer laser photorefractive keratectomy (PRK) and phototherapeutic keratectomy (PTK) to correct aberrations and refractive errors after radial keratotomy (RK) or keratoplasty. Sekal Rovigo Microsurgery Centre, Rovigo, Italy. This retrospective noncomparative consecutive case series comprised eyes having corneal wavefront-guided transepithelial PRK to correct aberrations followed by PTK (60 to 70 mum depth) without masking fluid. Corneal wavefront topography and a flying-spot excimer laser were used. Complete preoperative and postoperative ophthalmic examinations were performed. The mean age of the 26 patients (35 eyes; 17 RK, 18 keratoplasty) at surgery was 47 years +/- 9 (SD) (range 29 to 72 years) and the mean follow-up, 7 +/- 2 months (range 6 to 15 months). Preoperatively, all eyes had irregular astigmatism ranging from 0.50 to 6.50 diopters (D). At the last postoperative follow-up, the uncorrected distance visual acuity was better than 20/40 in 21 eyes (60%) and better than 20/20 in 6 eyes (17%); 25 eyes (71%) were within +/-1.00 D of the attempted spherical equivalent manifest refraction (mean -0.58 +/- 1.06 D; range -3.50 to +1.50 D). No eye lost Snellen lines of corrected distance visual acuity; 8 eyes (23%) had an increase of more than 4 lines. Trace haze developed in 1 eye. Simultaneous corneal wavefront-guided transepithelial PRK and PTK using an excimer laser was safe and effective in correcting aberrations and refractive errors after RK or keratoplasty. Neither author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes.

Camellin M ，Arba Mosquera S 《-》

Corneal wavefront-guided photorefractive keratectomy with mitomycin-C for hyperopia after radial keratotomy: two-year follow-up.

To assess corneal wavefront-guided photorefractive keratectomy (PRK) to correct hyperopia after radial keratotomy (RK). Sadalla Amin Ghanem Eye Hospital, Joinville, Santa Catarina, Brazil. Case series. Excimer laser corneal wavefront-guided PRK with intraoperative mitomycin-C (MMC) 0.02% was performed. Main outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical equivalent (SE), corneal aberrations, and haze. The mean time between RK and PRK in the 61 eyes (39 patients) was 18.8 years ± 3.8 (SD). Before PRK, the mean SE was +4.17 ± 1.97 diopters (D); the mean astigmatism, -1.39 ± 1.04 D; and the mean CDVA, 0.161 ± 0.137 logMAR. At 24 months, the mean values were 0.14 ± 0.99 D (P<.001), -1.19 ± 1.02 D (P=.627), and 0.072 ± 0.094 logMAR (P<.001), respectively; the mean UDVA was 0.265 ± 0.196 (P<.001). The UDVA was 20/25 or better in 37.7% of eyes and 20/40 or better in 68.9%. The CDVA improved by 1 or more lines in 62.3% of eyes. Two eyes (3.3%) lost 2 or more lines, 1 due to corneal ectasia. Thirty eyes (49.2%) were within ± 0.50 D of intended SE and 45 (73.8%) were within ± 1.00 D. From 6 to 24 months, the mean SE regression was +0.39 D (P<.05). A significant decrease in coma, trefoil, and spherical aberration occurred. Three eyes developed peripheral haze more than grade 1. Corneal wavefront-guided PRK with MMC for hyperopia after RK significantly improved UDVA, CDVA, and higher-order corneal aberrations with a low incidence of visually significant corneal haze.

Ghanem RC ，Ghanem VC ，Ghanem EA ，Kara-José N ... -  《-》

Wavefront-guided photorefractive keratectomy in eyes with prior radial keratotomy: a multicenter study.

Koch DD ，Maloney R ，Hardten DR ，Dell S ，Sweeney AD ，Wang L ... -  《-》

Topography-guided customized laser-assisted subepithelial keratectomy for the treatment of postkeratoplasty astigmatism.

Rajan MS ，O'Brart DP ，Patel P ，Falcon MG ，Marshall J ... -  《JOURNAL OF CATARACT AND REFRACTIVE SURGERY》

Consecutive myopia correction with transepithelial versus alcohol-assisted photorefractive keratectomy in contralateral eyes: one-year results.

To compare the postoperative efficacy, safety, and higher-order-aberrations (HOAs) between transepithelial photorefractive keratectomy (PRK) and alcohol-assisted PRK in contralateral eyes. Private clinic, Utrecht, The Netherlands. Comparative case series. Consecutive patients were randomized to have transepithelial PRK in 1 eye and alcohol-assisted PRK in the contralateral eye. In both eyes, aspheric treatments were planned with Custom Ablation Manager software and ablations performed with the Schwind Amaris system. Clinical outcomes were predictability, refraction, visual acuity, wavefront aberrations, and contrast and glare sensitivity. Paired t tests were applied for statistics. The study evaluated 66 eyes (33 patients). All patients completed the 1-year follow-up. At 1-year, 97% of eyes in both groups achieved an uncorrected distance visual acuity (UDVA) of 0.1 logMAR or better. No eye lost 2 or more lines of corrected distance visual acuity (CDVA); 97% of transepithelial PRK eyes and 91% of alcohol-assisted PRK eyes were within ±0.50 diopter (D) of the targeted refraction. The postoperative mean spherical equivalent was +0.07 D ± 0.23 (SD) and +0.01 ± 0.27 D, respectively. The CDVA, UDVA, and safety outcomes between transepithelial PRK and alcohol-assisted PRK were comparable. Profiles for both techniques applied to regular corneas preserved the eye's natural HOAs. Transepithelial PRK is faster to perform and it is an all-laser procedure, which might be less stressful for the patient. Mr. Ewering and Mr. Arba-Mosquera are employees of Schwind eye-tech-solutions. Dr. Luger has no financial or proprietary interest in any material or method mentioned.

Luger MH ，Ewering T ，Arba-Mosquera S 《-》