title: Topography-guided laser refractive surgery.
abstract: OBJECTIVE
  Topography-guided laser refractive surgery regularizes the front corneal surface irregularities to achieve the desired refractive outcome. This is particularly applicable in highly aberrated corneas, where wavefront aberrometry is often not possible. This article aims to review the recently published results of topography-guided ablations in normal regular corneas, highly aberrated corneas, and its application in conjunction with collagen cross-linking (CXL) in cases of keratectasia.
  
  
  RESULTS
  Topography-guided laser ablation is increasingly used with good efficacy and safety outcomes in highly aberrated corneas with irregular astigmatism. These include eyes with refractive surgery complications including postlaser in-situ keratomileusis ectasia, decentered ablation, small optical zones, asymmetrical astigmatism, and postradial keratectomy astigmatism. Further indications are for postkeratoplasty astigmatism and keratoconus. Simultaneous topography-guided ablations with CXL in keratectasia have been promising, both in addressing the surface irregularities and progressive nature of the conditions.
  
  
  CONCLUSIONS
  Topography-guided laser refractive surgery is proving to be effective and well tolerated in the visual rehabilitation of highly aberrated eyes, with increasing predictability based on the recent research.
authors.affiliation: Pacific Laser Eye Centre, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Holland
authors.forename: David T C
authors.initials: DT
authors.lastname: Lin
authors.forename: Johnson C H
authors.initials: JC
authors.lastname: Tan
mesh_terms: D003094:Collagen / Q000378:metabolism; D003131:Combined Modality Therapy; D003316:Corneal Diseases / Q000601:surgery*; D003319:Corneal Stroma / Q000378:metabolism; D019781:Corneal Topography / Q000379:methods*; D003432:Cross-Linking Reagents / Q000627:therapeutic use; D006801:Humans; D054140:Refractive Surgical Procedures / Q000379:methods*
chemical_list: D003432:Cross-Linking Reagents; D003094:Collagen