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Advanced surface ablation (LASEK/epi-LASEK) for extreme myopia, hyperopia and/or astigmatism

Poster Details

First Author: E.Chynn USA

Co Author(s):    J. Guo   S. Wong                 

Abstract Details

Purpose:

To determine whether extreme myopia, hyperopia, and/or astigmatism- past parameters for LASIK,may be safely and effectively treated with advanced surface ablation techniques (LASEK or epi-LASEK).

Setting:

Park Avenue LASEK

Methods:

Retrospective review of 118 patients (215 eyes) with extreme myopia, hyperopia, and/or astigmatism. SE for myopic eyes (78%) ranged from -9.00 to -22.75 D (mean -11.20 D); for hyperopic eyes (7%) +6.00 to +7.50 D (mean +6.94 D); and for astigmatic eyes (26%) -3.00 to -6.00 D cyl (mean = -3.63 D). 14% of eyes had refractive (anisometropic) amblyopia. All eyes underwent LASEK or epi-LASEK using a VISX S4IR excimer laser with intraoperative Mitomycin C (MMC) 0.01%. Both topical and oral steroids and oral Vitamin C were given postoperatively, as well as UV protection to reduce scarring risk.

Results:

UCVA at 1 month postop was on average19.2 lines better than preop UCVA.At 1 month postop,22% of treated eyes exhibited UCVA equal to preop BCVA,while 18% of eyes had UCVA better than preop BCVA.At 3 months postop, UCVA was on average 19.8 lines better than preop UCVA.UCVA at 3 months postop was equal to preop BCVA in 38% of eyes, and better than preop BCVA for 34% of eyes.Six (2.8%) of eyes exhibited clinically insignificant haze, with no loss of BCVA.The average improvement in UCVA measured at 6 or 12 months was not significantly different (P>0.05) from 3 months,suggesting improvement in UCVA was stable after 3 months.100% of eyes had an improvement in UCVA. No iatrogenic ectasia was observed .

Conclusions:

Extreme myopia, hyperopia, and astigmatism past LASIK parameters may be effectively and fully treated with advanced surface ablation techniques without inducing iatrogenic ectasia. Adjunctive therapy including oral steroids and MMC are effective in preventing clinically significant haze. UCVA can be uniformly improved, and postop UCVA may exceed preop BCVA in the majority of cases, due to reduction of minification and more accurate/complete refractive correction compared to spectacles or contacts.

Financial Disclosure:

NONE

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