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Visual outcomes of treating refractive error with excimer laser in the presence of map-dot-fingerprint (MDF) dystrophy

Poster Details

First Author: S.Mughal UK

Co Author(s):                        

Abstract Details

Purpose:

To evaluate the visual and clinical outcomes in terms of the efficacy and safety following LASIK and LASEK in patients with MDF dystrophy.

Setting:

One certified and experienced corneal laser surgeon practicing in the Optimax Laser Eye Clinics, United Kingdom performed all the surgeries.

Methods:

This case series was a retrospective analysis of 4 patients whose mean age was 52.7years (range: 49-55 years). A history of recurrent erosions was looked for and associated ocular and systemic risk factors identified. All patients were treated on the NIDEK EC5000 excimer laser (NIDEK Co Ltd, Gamagori, Japan) using either optimised aspheric or custom aspheric ablation profiles. The intended refractive aim for all eyes was emmetropia and there were no retreatments included. All eyes had at least 3 months of complete pre & postoperative visual and refractive data. Uncorrected distance visual acuity (UDVA) and refraction were evaluated.

Results:

The 2 patients that did have a past history of infrequent monocular recurrent erosions elected to have LASEK to treat myopia with astigmatism. Both had residual myopic astigmatism after 9 months retreated successfully with LASEK achieving UDVA of 20/20 and no further episodes of recurrent erosions were reported. Corneal haze was grade 1 or less in all 4 eyes. LASIK Intralase (FS60 kHz) 90 degree side cut angles flaps were performed on 2 patients who had low hyperopia with astigmatism with no associated risk factors and no history of recurrent erosions. No intraoperative flap complications or epithelial sloughing occurred and there was no postoperative epithelial ingrowth. UDVA was 20/20 in both cases.

Conclusions:

This case series highlights successful visual outcome in patients with MDF dystrophy attaining excellent vision with resolution of recurrent erosions additional to treatment of refractive error with surface laser treatment. Patients experiencing recurrent erosions are more likely to experience undercorrection. However, longer follow up and larger number of cases is required in order to effectively evaluate the safety of both LASEK and LASIK. The square edge of the flap side cut most likely confers reduced risk of epithelial ingrowth from abnormal epithelium. A thorough examination to rule out anterior basement membrane dystrophy and assess associated risk factors is necessitated.

Financial Disclosure:

NONE

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