Tomographic And Biomechanical Stability After Lasik In Eyes With High Superior–Inferior Corneal Asymmetry
Published 2026 - 44th Congress of the ESCRS
Reference: FP07.15 | Type: Free paper | DOI: 10.82333/p1w7-xg86
Authors: Prof. Dr Luis Izquierdo Jr* 1 , Dr Renzo Pomatanta 2 , Rolando Rojas 2 , A/Prof. Maria A Henriquez 2
1Research department,Oftalmosalud Institute of Eyes,Lima,Peru;San Fernando School of Medicine,Universidad Nacional Mayor de San Marcos,Lima,Peru, 2Research department,Oftalmosalud Institute of Eyes,Lima,Peru
Purpose
To evaluate long-term tomographic and biomechanical stability after LASIK in eyes with preoperative superior–inferior (S-I) corneal asymmetry
Setting
Oftalmosalud Institute, Lima, Peru.
Methods
Prospective longitudinal study of 45 eyes of 45 patients with S–I asymmetry >1.5 D and no ectatic pattern on tomography and biomechanics (define cutoffs if available: BAD-D/TBI/CBI/posterior elevation). All eyes underwent femtosecond-assisted LASIK. Preoperative and 18-month assessments included refraction, Pentacam tomography (Kmax, posterior elevation/curvature, thinnest pachymetry, BAD-D), and Corvis ST indices (TBI, CBI). Paired comparisons were performed using Wilcoxon signed-rank test.
Results
Forty-five eyes completed 18-month follow-up. Spherical equivalent improved from -5.29±4.95 D to -0.17±0.14 D, and cylinder from -0.92±[REVISAR SD] D to -0.08±[REVISAR SD] D. S–I curvature difference decreased from 3.03±1.50 D to 0.77±0.61 D (p=[ ]). Kmax remained stable (44.08±0.37 D vs 43.97±0.42 D; p=0.750). Posterior keratometry/elevation showed no significant change. Thinnest pachymetry did not demonstrate progressive thinning. BAD-D decreased from 2.20±0.76 to 1.74±0.58. TBI and CBI showed no postoperative deterioration. No eye developed clinical or tomographic ectasia.
Conclusions
In carefully selected eyes with high S–I asymmetry but normal tomographic and biomechanical screening, LASIK showed refractive efficacy and structural stability at 18 months. S–I asymmetry should be interpreted in the context of a comprehensive ectasia risk assessment rather than used as a standalone contraindication.