title: Transepithelial, Topography-guided Ablation in the Treatment of Visual Disturbances in LASIK Flap or Interface Complications.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of a single-step, transepithelial, topography-guided surface ablation in the treatment of visual disturbances including irregular astigmatism and light scattering caused by LASIK flap or interface complications.
  
  
  METHODS
  Seventeen eyes of 16 patients with LASIK flap or interface complications and central residual stromal thickness ≥300 μm were treated with a topography-guided custom transepithelial "no touch" (cTEN) technique using the iVIS Suite 1-kHz excimer laser (iVIS Technology). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction, corneal irregularity, ocular higher order aberrations (HOAs), and visual symptoms were analyzed.
  
  
  RESULTS
  Mean 15.9±11.0 months after surgery, mean UDVA improved from 20/87 to 20/25. Mean CDVA improved from 20/28 to 20/19 (P<.001), with 64.7% of eyes gaining two or more lines of CDVA. Mean corneal irregularity index decreased from 25.82 to 20.36 μm (P=.009). Mean root-mean-square (RMS) of total HOAs decreased from 1.30 to 0.49 (P=.042), whereas RMS of the odd-order (3rd and 5th) and even-order (4th and 6th) HOAs decreased from 0.85 to 0.38 (P=.001) and 0.43 to 0.24 (P=.036), respectively. All patients claimed their visual symptoms were better (8 eyes) or cured (9 eyes).
  
  
  CONCLUSIONS
  Corneal regularization and removal of the underlying flap or interface pathology by cTEN ablation appears to be an effective treatment for LASIK flap or interface complications associated with visually disturbing irregular astigmatism and light scattering in cases with sufficient residual stromal thickness.
authors.affiliation: SynsLaser Kirurgi AS, Tromsø, Norway. chenxiangjun1101@gmail.com
authors.forename: Xiangjun
authors.initials: X
authors.lastname: Chen
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Stojanovic
authors.forename: Wen
authors.initials: W
authors.lastname: Zhou
authors.forename: Tor Paaske
authors.initials: TP
authors.lastname: Utheim
authors.forename: Filip
authors.initials: F
authors.lastname: Stojanovic
authors.forename: Qinmei
authors.initials: Q
authors.lastname: Wang
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D019781:Corneal Topography; D019573:Epithelium, Corneal; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008027:Light; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012542:Scattering, Radiation; D013524:Surgical Flaps / Q000009:adverse effects*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology