Topography-Guided Transepithelial Surface Ablation in the Treatment of Moderate to High Astigmatism.
OBJECTIVE
To analyze the outcomes of treatment of astigmatism of 2.00 diopters (D) or greater with topography-guided transepithelial surface ablation.


METHODS
Retrospective analysis of a series of 206 eyes divided into two groups: myopic astigmatism (153 eyes) and mixed astigmatism (53 eyes). All cases were treated with topography-guided transepithelial surface ablation. Efficacy, safety, and predictability were evaluated, and vector analysis of cylindrical correction was performed.


RESULTS
The median preoperative spherical equivalent was -2.63 and -0.63 D for the myopic and mixed astigmatism groups, respectively, with median cylinder of -2.50 D. Postoperative uncorrected distance visual acuity was 20/20 or better in 92% and 83% of eyes in the myopic and mixed astigmatism groups, respectively; the corresponding efficacy indices were 1.00 and 0.96 and residual astigmatism of 0.50 D or less was present in 82.4% and 56.7% of eyes in the myopic and mixed astigmatism groups, respectively. The arithmetic mean magnitude of the difference vector was 0.38 (myopic) and 0.65 (mixed) D. Difference vector magnitude was positively correlated with the magnitude of target induced astigmatism in both groups. The geometric mean coefficient of adjustment index was 1.04 and 1.19, representing undercorrection of 4% and 19% in the myopic and mixed astigmatism groups, respectively.


CONCLUSIONS
Topography-guided transepithelial ablation is a safe, effective, and predictable treatment for moderate to high astigmatism. [J Refract Surg. 2016;32(6):418-425.].
Xiangjun
X
Chen
Aleksandar
A
Stojanovic
David
D
Simonsen
Xiaorui
X
Wang
Yanhua
Y
Liu
Tor Paaske
TP
Utheim
D000328:Adult; D001251:Astigmatism / Q000145:classification / Q000601:surgery*; D048988:Corneal Surgery, Laser / Q000379:methods*; D019781:Corneal Topography; D019573:Epithelium, Corneal / Q000601:surgery*; D005260:Female; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology