Purpose: To assess the efficacy and safety of corneal wavefront-guided custom laser in situ keratomileusis (LASIK) to correct refractive errors and higher-order aberrations (HOAs) after penetrating keratoplasty (PKP).
Setting: Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
Design: Noncomparative case series.
Methods: The study comprised consecutive patients who were unable to tolerate spectacles or contact lenses for the correction of anisometropia after PKP and had corneal wavefront-guided custom LASIK. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction spherical equivalent (MRSE), and corneal HOAs were recorded before and after LASIK.
Results: The study evaluated 11 eyes (10 patients). The mean follow-up after LASIK was 24.3 months ± 11.7 (SD) (range 9 to 36 months). The mean MRSE was -2.97 ± 1.66 diopters (D) (range -0.50 to -5.38 D) preoperatively and -0.88 ± 0.96 D (range -2.75 to 0.5 D) postoperatively. The mean total higher-order root mean square (RMS) was 4.65 ± 1.14 μm (range 2.26 to 5.94 μm) preoperatively and 2.71 ± 1.31 μm (range 1.22 to 5.33 μm) postoperatively. Postoperatively, the UDVA improved in 7 eyes and remained unchanged in 4 eyes. The CDVA improved in all eyes postoperatively even cases in which the attempted astigmatic correction was not totally achieved.
Conclusions: Corneal wavefront-guided custom LASIK after PKP did not totally correct both refractive errors and HOAs because of the high volume of laser ablation required and inadequate corneal stromal thickness.
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http://dx.doi.org/10.1016/j.jcrs.2013.10.042 | DOI Listing |
Eye Contact Lens
February 2025
Cornea and Laser Eye Institute-CLEI Center for Keratoconus (J.D.G., B.S., T.P., C.E., P.S.H., S.A.G.), Teaneck, NJ; Department of Ophthalmology (J.D.G., D.K., P.S.H., S.A.G.), Rutgers-New Jersey Medical School, Newark, NJ; TX; OVITZ Corporation (N.B., J.W.), Rochester, NY; College of Optometry (G.Y.), University of Houston, Houston, TX.
Purpose: To report interim results of a single center, randomized, double-blind, crossover-controlled clinical trial comparing wavefront-guided (wfg) scleral lenses (SLs) to traditional scleral lenses (tSLs) for patients with a history of irregular corneal astigmatism (ICA).
Methods: Thirty-one ICA eyes of 18 participants were reviewed, 23 with keratoconus, six postcorneal refractive ectasia, and two postpenetrating keratoplasty. Patients with corneal or lens opacities were not excluded from participating.
J Pers Med
October 2024
Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy.
Corneal ectasias, including keratoconus (KC), pellucid marginal degeneration (PMD), and post-LASIK ectasia, poses significant visual rehabilitation challenges due to the resultant irregular astigmatism, myopia, and higher-order aberrations (HOAs). These conditions often resist traditional corrective methods, necessitating advanced optical solutions. Scleral lenses (SLs) have emerged as a primary non-surgical option for managing these complex corneal irregularities.
View Article and Find Full Text PDFIndian J Ophthalmol
January 2025
Department of Ophthalmology, Command Hospital (Eastern Command), Kolkata, West Bengal, India.
Purpose: To describe the role of wavefront-guided pupilloplasty in improving visual quality and wavefront parameters in post-keratoplasty patients with pathologically irregular, mydriatic pupils.
Methods: A total of 13 eyes of post-penetrating keratoplasty patients with pathologically irregular mydriatic pupil were included in this prospective interventional study. Preoperative wavefront analysis was done with the actual pupil size, and predicted wavefront values were analyzed by setting the postoperative pupil size to 2 mm.
Purpose: To compare haze and refractive outcomes in patients undergoing combined accelerated corneal cross-linking (A-CXL) and selective wavefront-guided transepithelial photorefractive keratectomy (WG-transPRK) without mitomycin C (MMC) versus those undergoing A-CXL.
Methods: This prospective study analyzed 95 eyes (86 patients) with progressive keratoconus from October 2018 to October 2022. The first group underwent CXL combined with corneal or ocular WG-transPRK (CXL+PRK, n = 52), targeting higher order aberrations (HOAs).
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