A Novel Corneal Remodeling Technique of Laser Asymmetric Keratectomy in Keratoconus Suspect: A Retrospective Case Control Study

Abstract

Purpose This retrospective case control study report includes 4 eyes of 4 patients (aged from 37 to 44 years) with keratoconus suspect (KCS) who underwent laser epithelial keratomileusis linked laser asymmetric keratectomy (L-LAK) as corneal remodeling technique in order to avoid postoperative corneal ectasia. Patients and Methods Four eyes of 4 patients showed corneal topography findings with abnormal localized steep keratometric curvature greater than 47.0 D and peripheral corneal thickness asymmetry (Total corneal central thickness deviations in four directions on Orbscan map (SUM)≥80 µm). L-LAK could be performed both the original ablation of refractive errors (SE from −1.25 to −5.50 D) and the customized ablation (selective ablation of the thicker peripheral cornea averaging:64 µm selectively and the central cornea of the myopic shift due to LAK averaging-1.50D. The main outcome measures between preoperative and postoperative 2 year were refraction, visual acuity (UDVA), keratometry, corneal symmetry evaluating SUM. Results After 2 years, SEs (D, average) were −0.34, UDVA (LogMAR) was 0.00. keratometry including Kmax was markedly decreased, SUM had diminished markedly. There were no case of postoperative adverse effects. Conclusion L-LAK resulted in a decreased SUM, increased corneal symmetry, and no postoperative corneal ectasia with good visual outcomes in myopic patients with KCS.