Topographically guided excimer laser photorefractive keratectomy to treat superficial corneal opacities.
OBJECTIVE
To demonstrate the efficacy and safety of topographically guided excimer laser photorefractive keratectomy (PRK) in treating superficial corneal opacities.


METHODS
Prospective, noncomparative interventional case series.


METHODS
Twenty-six eyes of 24 patients with postinfectious (n = 6), post-traumatic (n = 18), and post-PRK (n = 2) scars were treated with an excimer laser linked to a computerized videokeratography unit with a topographically supported customized ablation workstation.


METHODS
Manifest spectacle refraction, best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), change of corneal clarity, and topographic indexes of surface regularity.


RESULTS
The mean follow-up period was 7.7+/-2.1 months (+/- standard deviation) (range = 6-12). Corneal clarity and corneal topography patterns improved in all eyes. Uncorrected visual acuity improved from 0.7+/-0.8 logarithm of the minimum angle of resolution (logMAR) to 0.4+/-0.5 logMAR (P = 0.008), and BSCVA improved from 0.3+/-0.6 logMAR to 0.1+/-0.6 logMAR (P<0.001). The BSCVA increased in all eyes (>/=2 lines in 76.9% of eyes and 1 line in 23.1%). The mean spherical equivalent refraction changed from -0.125+/-2.77 diopters (D) to +1.33+/-1.28 D (P = 0.019).


CONCLUSIONS
The use of topographically guided PRK with the topographically supported customized ablation method resulted in significant increases of UCVA and BSCVA and improved corneal clarity in all patients. The technique seems to be safe and effective for treating various superficial corneal diseases, including postinfectious, post-traumatic, and post-PRK scars.
Spadea
Leopoldo
L
Università degli Studi di L'Aquila, L'Aquila, Italy. lspadea@cc.univaq.it
Bianco
Guido
G
Balestrazzi
Emilio
E
D000328:Adult; D000368:Aged; D003318:Corneal Opacity / Q000601:surgery*; D019781:Corneal Topography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012029:Refraction, Ocular; D012449:Safety; D014792:Visual Acuity