ESCRS - P094 - REFRACTIVE SURGERY ON DEMAND: CUSTOM-MADE TOPOGRAPHY-GUIDED ABLATION. A GOOD SOLUTION FOR THE CORRECTION OF IRREGULAR ASTIGMATISM.

REFRACTIVE SURGERY ON DEMAND: CUSTOM-MADE TOPOGRAPHY-GUIDED ABLATION. A GOOD SOLUTION FOR THE CORRECTION OF IRREGULAR ASTIGMATISM.

Published 2022 - 26th ESCRS Winter Meeting

Reference: P094 | Type: Abstracts | DOI: 10.82333/5tmh-tz53

Authors: Alba Marin* 1 , Carlos Martin 2

1Opthalmology,Hospital de la Santa Creu i Sant Pau,Barcelona,Spain;Opthalmology,Admiravisión,Barcelona,Spain, 2Opthalmology,Admiravisión,Barcelona,Spain

Purpose

To present a case of correction of irregular astigmatism by customized ablation guided by topography.

Setting

We present a case of a patient with a history of phacoemulsification + trifocal-toric IOL implantation in both eyes who remained with residual ametropia consisting in irregular astigmatism, which we decided to correct by performing a customized PRK-type ablation guided by topography.

Methods

We present a case of a patient with a history of phacoemulsification + trifocal-toric IOL implantation in both eyes who remained with residual ametropia, for which a bioptic PRK (photorefractive keratotomy) was performed in both eyes. After performing the technique, the patient reported persistence of poor visual acuity (VA) in the right eye that did not improve with optical correction (VA = 0.6). The fundus examination and the biomicroscopy exam were unremarkable. The corneal topography revealed the presence of large central irregular astigmatism and an OQAS (optical quality analysis system) test was performed, being very altered in the right eye. De-epithelialization was performed with persistence of VA = 0.6. Eventually, we decided to perform customized PRK-type ablation guided by topography for the correction of irregular astigmatism

Results

The applied method achieved a significant reduction in the patient's irregular astigmatism, with a significant improvement in the topographic profile and achieving a VA = 1.0 with optical correction in the treated eye

Conclusion

Refractive surgery achieves good visual quality without optical correction in most cases. Nevertheless, conventional ablation methods have limited efficacy in irregular corneas, where custom-made topography-guided ablation has proven to be a better option; achieving a significant reduction in irregular astigmatism and an improvement in BCVA (best corrected visual acuity) with a very low complication rate.