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Topo-guided LASIK for correction of complex myopic astigmatism in combination with refractive amblyopia and asthenopic syndrome: clinical case

Poster Details

First Author: O.Napylova RUSSIA

Co Author(s):    L. Ramazanova   E. Yazykova   R. Shamratov   K. Protasova   E. Pavlova   R. Alieva     

Abstract Details


Analyze the anatomical and functional results of topo-guided LASIK in a patient with complex myopic astigmatism in combination with refractive amblyopia and asthenopic syndrome.


Private Healthcare Institution «Medical Sanitary Unit»


Patient, 25 y.o,addressed with complaints of low visual acuity,asthenopic syndrome and intolerance of correction from childhood. After conducting a standard ophthalmological examination, the following data were obtained: Visual acuity without correction: OD= 20/200 OS=20/200. Spherical equivalent OD=3,0D/OS=3,25D. Cylindrical equivalent OD=1,25D/OS=1,0D. Maximum visual acuity with correction OD=20/40 OS =20/40.Ultrasound Biometrics: OD= 24.00/OS =24.06mm. Pachymetry: OD= 553/OS =545. Keratotopography OD/OS:pronounced decentralization. The personalized ablation was carried out using the software "Contoura" of the Allegretto WaveLight EX 500 excimer laser (Alcon), with a diameter of the optical zone of 6.5 mm. Thickness of corneal flap = 100 μm (mechanical microkeratome Moria Evolution 3E).


The examination on the 1st day after the operation showed: visual acuity without correction OD = 20/20 OS = 20/20, spherical equivalent OD = 0.0 D / OS = 0.0 D. Cylindrical equivalent OD = 0.25D / OS = 0.25D. The examination after 1 month showed similar data. The analysis of the examination performed on the 1st day after the operation and after 1 month showed a visual acuity stably exceeding the maximum corrected visual acuity before the operation, due to a decrease in the degree of astigmatism to the physiological and absence of higher order aberrations.


Low visual acuity and intolerance of spectacle or contact correction from childhood, formed in the patient a functional condition, characteristic of refractive amblyopia with a pronounced asthenopic syndrome.The use of the personalized ablation program «Contoura» made it possible to form a new corneal profile in this patient, to obtain a stable high visual acuity (above the maximum corrected visual acuity before surgery), to relieve the patient of asthenopic complaints, and to significantly improve the quality of his life.

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