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Topography-guided excimer laser procedure: treatment of corneal irregularity and stromal scar

Poster Details

First Author: M.Belovari Visnjic CROATIA

Co Author(s):    I. Knezovic   M. Goldgouber           

Abstract Details


To report a case of corneal topographic irregularity with stromal scar treated with topography-guided excimer laser procedure.


Knezovic vision group, Zagreb, Croatia


A 38 years old male was sent to our eye center due to decreased visual acuity on the right eye and suspected keratoconus. Eye examination on his right eye showed: uncorrected and best corrected visual acuity (UCVA and BCVA) 0,2 and 0.5; slit lamp biomicroscopy showed stromal scar in central superior corneal part. Scheimpflug imaging (Oculyzer, Wavelight) marked high corneal irregularity, without evident keratoconus topographic signs. Anterior optical coherence tomography (OCT) imaging indicated no significant corneal epithelial discrepancy in central 8 mm zone. Phototherapeutic keratectomy (PTK) with ablation depth of 50 microns was used for epithelial removal, followed by topography-guided photorefractive keratectomy (topo-guided PRK), both procedures performed using Allegretto Wavelight eyeQ 400Hz excimer laser device. UCVA, BCVA, Scheimpflug images of corneal symmetry, indexes of corneal regularity - index of surface variance (ISV), index of vertical asymmetry (IVA) and smallest sagittal curvature in eight mm central optical zone (Rmin) were analyzed pre- and postoperatively during the 10 months follow-up period.


One month after the treatment UCVA and BCVA were significantly increased. Corneal stromal scar was reduced. All tomographic parameters showed improvement toward normal values during the 10 months follow-up period.


Topography-guided corneal procedure showed promising results in treatment of highly irregular corneas. Recently, attention has been focused on this procedure because of its unique therapeutic benefits. FINANCIAL INTEREST: NONE

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