Photorefractive Keratectomy Modification of Postkeratoplasty Anisometropic Refractive Errors

Ward, Matthew S.; Wandling, George R.; Goins, Kenneth M.; Sutphin, John E.; Kitzmann, Anna S.; Wagoner, Michael D.

doi:10.1097/ico.0b013e31824a22a4

Cited by 13 publications

(24 citation statements)

References 40 publications

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“…They reported results comparable to a published series of post‐keratoplasty eyes treated with LASIK, with an eight per cent loss of two lines of visual acuity and no cases of severe haze. Similarly, Ward and colleagues in a retrospective case review of 20 eyes with post‐keratoplastic anisometropia reported 100 per cent patient satisfaction with 90 per cent having a visual acuity of better than 6/12, 50 per cent of eyes gaining one to two lines of visual acuity, a mean reduction in astigmatism of 2.9 D and loss of two lines of visual acuity in a single eye.…”

Section: Surface Ablation In Eyes With Previous Corneal Surgerymentioning

confidence: 90%

Excimer laser surface ablation: a review of recent literature

O’Brart

2014

Clinical and Experimental Optometry

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The aim was to review the recently published literature on excimer laser surface ablation procedures, including photorefractive keratectomy (PRK), laser sub-epithelial keratomileusis (LASEK), microkeratome-assisted PRK (epi-LASIK) and trans-epithelial (laser-assisted) PRK, to help elucidate where and how surface ablation may best fit into current refractive surgical practice. The emphasis was on publications within the last three years and included systemic reviews, meta-analyses and randomised controlled trials. Where such evidence did not exist, selective large series cohort studies, case-controlled studies and case series with follow-up preferably greater than six months were examined and included. Refractive and visual outcomes are excellent and comparable to those after LASIK even in complex cases after previous corneal surgery. Indeed, surface ablation combined with corneal collagen cross-linking may be used in selected eyes with biomechanical instability, where LASIK is contraindicated. In addition, there is evidence to suggest that there may be less induction of higher order aberrations with surface techniques. Long-term stability and safety appear to be extremely satisfactory. The literature supports the use of modern excimer laser surface treatments, with outcomes comparable to those after LASIK and evidence of less induction of higher-order aberrations. Follow-up studies at 10 to 20 years indicate excellent stability and safety.

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Section: Surface Ablation In Eyes With Previous Corneal Surgerymentioning

confidence: 90%

Excimer laser surface ablation: a review of recent literature

O’Brart

2014

Clinical and Experimental Optometry

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“…Under corrections were more common than overcorrections especially when the spherical and astigmatic errors were more than 5D. 75…”

Section: E-issn 0976-2892mentioning

confidence: 97%

Postkeratoplasty Astigmatism

Raghavan¹

2015

Delhi Journal of Ophthalmology

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The success of penetrating keratoplasty in terms of graft survival is excellent but visual rehabilitation continues to be a significant issue primarily due to astigmatism. Factors contributing to postoperative astigmatism can be related to preoperative etiology, suturing techniques and the postoperative healing process and timing of surgery. The large number of options available to address postoperative astigmatism only serves to highlight the complex nature of the problem. This review offers an up-to-date account of the various options available to manage postkeratoplasty astigmatism. Spectacles and rigid gas-permeable (RGP) contact lenses offer the earliest and easiest forms of visual rehabilitation. Spectacle correction may be limited by astigmatic anisometropia. Rigid gas-permeable contact lenses are an effective alternative to spectacles but limited by fitting and handling issues. Suture adjustment and suture removal are the initial options for reducing postoperative astigmatism. Careful attention to suture techniques intraoperatively and timely removal of appropriate sutures in the postoperative period can decrease astigmatism to tolerable levels. For the management of residual astigmatism after suture removal, a plethora of choices exist. Relaxing incisions, astigmatic keratotomy, compression sutures and wedge resections are well explored techniques offering effective but unpredictable results. Photorefractive keratectomy and laser in situ keratomileusis are newer options available to correct both spherical and astigmatic errors, but outcomes are variably affected by the healing process. The current availability of phakic and toric intraocular lenses has also been explored for the correction of postkeratoplasty astigmatism with promising results. Intra-corneal ring segments used for the management of astigmatism in keratoconus finds a new application in postkeratoplasty astigmatism. The femtosecond laser has opened up ways to perform procedures such as astigmatic keratotomy, the placement of intra-corneal ring segments, and creation of flaps for laser in situ keratomileusis, with very good precision and accuracy.

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“…The mean postoperative astigmatism has been reported to typically range from 3 to 6 diopters (D), 1-3 but can exceed 10 D 4,5 after penetrating keratoplasty (PKP). Traditional treatment options for postkeratoplasty refractive errors have included spectacles, hard contact lenses, and corneal refractive procedures including compression sutures, astigmatic keratotomies, 4 wedge resections, 5 laser in situ keratomileusis, 6,7 photorefractive keratectomy, 8,9 and intracorneal ring segments. 10 Intraocular options have included sulcus-based conventional intraocular lenses (IOLs), 11 posterior chamber intraocular collamer lenses, 12 and iris-fixated lenses.…”

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confidence: 99%