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Corneal apical scar after hyperopic excimer laser refractive surgery: long-term follow-up of treatment with sequential customized therapeutic keratectomy (SCTK)

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Session Details

Session Title: Advanced Surface Photoablation

Session Date/Time: Tuesday 10/10/2017 | 09:00-10:20

Paper Time: 09:24

Venue: Room 4.1

First Author: : R.Vinciguerra ITALY

Co Author(s): :    F. Camesasca   E. Morenghi   S. Trazza   C. Azzolini   P. Vinciguerra        

Abstract Details


To evaluate long-term results of Sequential Customized Therapeutic Keratectomy (SCTK) in highly aberrated corneas with apical scars consequent to previous hyperopic excimer laser refractive surgery.


Humanitas Clinical and Research Center, Rozzano, Milan, Italy


Fifteen eyes of 12 patients treated with SCTK for corneal scar after hyperopic excimer laser refractive surgery were retrospectively evaluated. SCTK is a sequence of custom therapeutic excimer laser keratectomies where the results are progressively monitored step-by-step by intraoperative corneal topographies. In the preoperative and postoperative course, best corrected visual acuity (BCVA), corneal topography and aberrometry, Scheimpflug tomography as well as anterior segment optical coherence tomography were compared before and after SCTK.


The post-operative follow-up comprised 7 patients with one-year and 8 of patients with more than two years.Functional results showed a significant increase of BCVA starting from 0.53±0.26 Snellen to 0.80±0.26 at the last available follow up.Mean sphere did not change significantly,demonstrating that SCTK does not induce hyperopic shift.High order aberrations decreased significantly from 2.57±1.92µm to 0.80±0.42µm.Topographic indexes such as irregular astigmatism index, surface asymmetry index and surface regularity index showed a significant improvement after SCTK.Pachymetry results showed, after month 3, no significant reduction, demonstrating the stability obtained by the procedure in time


Long-term results demonstrates that SCTK is able to treat this sight-threatening complication of hyperopic excimer laser refractive surgery, obtaining significant improvement in visual acuity as well as of many corneal morphological parameters.

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