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Volume 111, Issue 3, Pages 458-462 (March 2004)


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Topographically guided excimer laser photorefractive keratectomy to treat superficial corneal opacities

Leopoldo Spadea, MD1Corresponding Author Informationemail address, Guido Bianco, MD1, Emilio Balestrazzi, MD1

Received 3 October 2002; accepted 3 June 2003.

Abstract 

Objective

To demonstrate the efficacy and safety of topographically guided excimer laser photorefractive keratectomy (PRK) in treating superficial corneal opacities.

Design

Prospective, noncomparative interventional case series.

Methods

Twenty-six eyes of 24 patients with postinfectious (n = 6), post-traumatic (n = 18), and post-PRK (n = 2) scars were treated with an excimer laser linked to a computerized videokeratography unit with a topographically supported customized ablation workstation.

Main outcome measures

Manifest spectacle refraction, best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), change of corneal clarity, and topographic indexes of surface regularity.

Results

The mean follow-up period was 7.7±2.1 months (± standard deviation) (range = 6–12). Corneal clarity and corneal topography patterns improved in all eyes. Uncorrected visual acuity improved from 0.7±0.8 logarithm of the minimum angle of resolution (logMAR) to 0.4±0.5 logMAR (P = 0.008), and BSCVA improved from 0.3±0.6 logMAR to 0.1±0.6 logMAR (P<0.001). The BSCVA increased in all eyes (≥2 lines in 76.9% of eyes and 1 line in 23.1%). The mean spherical equivalent refraction changed from −0.125±2.77 diopters (D) to +1.33±1.28 D (P = 0.019).

Conclusions

The use of topographically guided PRK with the topographically supported customized ablation method resulted in significant increases of UCVA and BSCVA and improved corneal clarity in all patients. The technique seems to be safe and effective for treating various superficial corneal diseases, including postinfectious, post-traumatic, and post-PRK scars.

1 Università degli Studi di L'Aquila, L'Aquila, Italy

Corresponding Author InformationCorrespondence and reprint requests to Leopoldo Spadea, MD, Via Benozzo Gozzoli 34, 00142 Rome, Italy.

 Manuscript no. 220785.

None of the authors has a financial or proprietary interest in any product or companies cited in the article.

PII: S0161-6420(03)01231-4

doi:10.1016/j.ophtha.2003.06.002


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