The Use Of Idesign 2.0 Refractive System, That Uses Topography-Integrated, Wavefront-Guided Technology To Correct Irregular Astigmatism Caused By Irregular Lasik Ablation.

To report a case of irregular astigmatism due to irregular lasik ablation , which was successfully treated with the Idesign2.0 Refractive Studio(Johnson &Johnson Vision) that uses topography-integrated and wavefront-guided technology, producing favorable final visual outcome.

Vista Eye Specialist Center, Malaysia

Mr M , a 40-year-old gentleman, had undergone  standard lasik treatment on both eyes.  Due to sudden eye movement during the excimer laser ablation, his left eye ended up with irregular ablation, causing irregular astigmatism on the left eye. His experienced reduced best corrected visual acuity to 20/50 on the left eye. The refraction on the left eye was -2.00D/-1.00D 20/250. Orbscan II and Pentacam showed irregular cornea surface due to the irregular excimer laser ablation on the left eye. His right eye was normal with visual acuity 20/20.  Mr M was fitted with rigid gas permeable rigid lens for visual rehabilitation on the left eye while waiting for a permanent solution. His uncorrected visual acuity was 20/20 with the RGP lenses. 12 months later, as the refraction stabilised, a carefully planned retreatment with lasik was done using Idesign 2.0 Refractive Studio, which uses topography-integrated, wavefront-guided system. After the retreatment, his left eye uncorrected visual accuity was 20/20 with no other visual disturbances. 

Irregular astigmatism is a possible complication in lasik that causes reduction of best corrected visual acuity in patients. The management  of these cases remains challenging due to irregular cornea surface. With the use of the new topography-integrated and wavefront-guided system in Idesign 2.0 Refractive Studio, good visual outcome is possible with the lasik retreatment of these cases.