Method for optimizing topography-guided ablation of highly aberrated eyes with the ALLEGRETTO WAVE Excimer Laser

David T.C. Lin, Simon P. Holland, Karolinne Maia Rocha, Ronald R. Krueger

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

PURPOSE: To evaluate the clinical outcomes of custom topographic neutralizing technique in treating highly aberrated eyes using the WaveLight ALLEGRETTO WAVE Excimer Laser. METHODS: A retrospective consecutive case series of 67 eyes with decentered ablations and 48 eyes with symptomatic small optical zones after previous LASIK underwent topography-guided retreatment with the ALLEGRETTO WAVE. Sixteen keratoconus eyes underwent topographic neutralizing technique photorefractive keratectomy (PRK). The study assessed preoperative and 6-month and 1-year postoperative results regarding best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), topography, and predictability. RESULTS: Sixty-seven eyes with previously decentered optical zones had an improvement of centration from 0.92 mm preoperatively to 0.30 mm postoperatively relative to pupil center (P<.01). Twenty-nine percent of these eyes gained 1 or more lines of BSCVA, whereas 71% had no change in BSCVA. Forty-eight eyes with previously small optical zones had an increase of the central monodioptric optical zone from 3.9 mm to 5.6 mm (P<.01). Nineteen percent of eyes had an improvement of at least 1 line, whereas 75% had no change in BSCVA and 6% lost 1 line. Sixteen keratoconus eyes had custom topographic neutralizing technique PRK as an alternative to penetrating keratoplasty. All eyes had improvement of astigmatism up to 5.00 diopters (D), with a mean change of 1.68±1.62 D. Best spectacle-corrected visual acuity was unchanged in 8 (50%) eyes, with 4 (25%) eyes gaining 1 tine, 2 (12%) eyes gaining 2 lines, and 2 (12%) eyes losing 1 line of BSCVA at 6 months. CONCLUSIONS: Management of some highly aberrated eyes is now possible with topography-guided ablation using the WaveLight ALLEGRETTO platform and custom topographic neutralizing technique. Safety was acceptable for small optical zone and decentered ablation retreatments. The topography-guided ablation could be an alternative treatment for keratoconus patients if keratoplasty is otherwise indicated. The algorithms for custom topographic neutralizing technique need further refinement.

Original languageEnglish (US)
Pages (from-to)S439-S445
JournalJournal of Refractive Surgery
Volume24
Issue number4
StatePublished - Apr 1 2008

Fingerprint

Excimer Lasers
Visual Acuity
Keratoconus
Photorefractive Keratectomy
Retreatment
Laser In Situ Keratomileusis
Penetrating Keratoplasty
Corneal Transplantation
Astigmatism
Pupil

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology

Cite this

Method for optimizing topography-guided ablation of highly aberrated eyes with the ALLEGRETTO WAVE Excimer Laser. / Lin, David T.C.; Holland, Simon P.; Rocha, Karolinne Maia; Krueger, Ronald R.

In: Journal of Refractive Surgery, Vol. 24, No. 4, 01.04.2008, p. S439-S445.

Research output: Contribution to journalArticle

@article{399bce54d9914c7f93bfc8420145f74c,
title = "Method for optimizing topography-guided ablation of highly aberrated eyes with the ALLEGRETTO WAVE Excimer Laser",
abstract = "PURPOSE: To evaluate the clinical outcomes of custom topographic neutralizing technique in treating highly aberrated eyes using the WaveLight ALLEGRETTO WAVE Excimer Laser. METHODS: A retrospective consecutive case series of 67 eyes with decentered ablations and 48 eyes with symptomatic small optical zones after previous LASIK underwent topography-guided retreatment with the ALLEGRETTO WAVE. Sixteen keratoconus eyes underwent topographic neutralizing technique photorefractive keratectomy (PRK). The study assessed preoperative and 6-month and 1-year postoperative results regarding best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), topography, and predictability. RESULTS: Sixty-seven eyes with previously decentered optical zones had an improvement of centration from 0.92 mm preoperatively to 0.30 mm postoperatively relative to pupil center (P<.01). Twenty-nine percent of these eyes gained 1 or more lines of BSCVA, whereas 71{\%} had no change in BSCVA. Forty-eight eyes with previously small optical zones had an increase of the central monodioptric optical zone from 3.9 mm to 5.6 mm (P<.01). Nineteen percent of eyes had an improvement of at least 1 line, whereas 75{\%} had no change in BSCVA and 6{\%} lost 1 line. Sixteen keratoconus eyes had custom topographic neutralizing technique PRK as an alternative to penetrating keratoplasty. All eyes had improvement of astigmatism up to 5.00 diopters (D), with a mean change of 1.68±1.62 D. Best spectacle-corrected visual acuity was unchanged in 8 (50{\%}) eyes, with 4 (25{\%}) eyes gaining 1 tine, 2 (12{\%}) eyes gaining 2 lines, and 2 (12{\%}) eyes losing 1 line of BSCVA at 6 months. CONCLUSIONS: Management of some highly aberrated eyes is now possible with topography-guided ablation using the WaveLight ALLEGRETTO platform and custom topographic neutralizing technique. Safety was acceptable for small optical zone and decentered ablation retreatments. The topography-guided ablation could be an alternative treatment for keratoconus patients if keratoplasty is otherwise indicated. The algorithms for custom topographic neutralizing technique need further refinement.",
author = "Lin, {David T.C.} and Holland, {Simon P.} and Rocha, {Karolinne Maia} and Krueger, {Ronald R.}",
year = "2008",
month = "4",
day = "1",
language = "English (US)",
volume = "24",
pages = "S439--S445",
journal = "Journal of Refractive Surgery",
issn = "0883-0444",
publisher = "Slack Incorporated",
number = "4",

}

TY - JOUR

T1 - Method for optimizing topography-guided ablation of highly aberrated eyes with the ALLEGRETTO WAVE Excimer Laser

AU - Lin, David T.C.

AU - Holland, Simon P.

AU - Rocha, Karolinne Maia

AU - Krueger, Ronald R.

PY - 2008/4/1

Y1 - 2008/4/1

N2 - PURPOSE: To evaluate the clinical outcomes of custom topographic neutralizing technique in treating highly aberrated eyes using the WaveLight ALLEGRETTO WAVE Excimer Laser. METHODS: A retrospective consecutive case series of 67 eyes with decentered ablations and 48 eyes with symptomatic small optical zones after previous LASIK underwent topography-guided retreatment with the ALLEGRETTO WAVE. Sixteen keratoconus eyes underwent topographic neutralizing technique photorefractive keratectomy (PRK). The study assessed preoperative and 6-month and 1-year postoperative results regarding best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), topography, and predictability. RESULTS: Sixty-seven eyes with previously decentered optical zones had an improvement of centration from 0.92 mm preoperatively to 0.30 mm postoperatively relative to pupil center (P<.01). Twenty-nine percent of these eyes gained 1 or more lines of BSCVA, whereas 71% had no change in BSCVA. Forty-eight eyes with previously small optical zones had an increase of the central monodioptric optical zone from 3.9 mm to 5.6 mm (P<.01). Nineteen percent of eyes had an improvement of at least 1 line, whereas 75% had no change in BSCVA and 6% lost 1 line. Sixteen keratoconus eyes had custom topographic neutralizing technique PRK as an alternative to penetrating keratoplasty. All eyes had improvement of astigmatism up to 5.00 diopters (D), with a mean change of 1.68±1.62 D. Best spectacle-corrected visual acuity was unchanged in 8 (50%) eyes, with 4 (25%) eyes gaining 1 tine, 2 (12%) eyes gaining 2 lines, and 2 (12%) eyes losing 1 line of BSCVA at 6 months. CONCLUSIONS: Management of some highly aberrated eyes is now possible with topography-guided ablation using the WaveLight ALLEGRETTO platform and custom topographic neutralizing technique. Safety was acceptable for small optical zone and decentered ablation retreatments. The topography-guided ablation could be an alternative treatment for keratoconus patients if keratoplasty is otherwise indicated. The algorithms for custom topographic neutralizing technique need further refinement.

AB - PURPOSE: To evaluate the clinical outcomes of custom topographic neutralizing technique in treating highly aberrated eyes using the WaveLight ALLEGRETTO WAVE Excimer Laser. METHODS: A retrospective consecutive case series of 67 eyes with decentered ablations and 48 eyes with symptomatic small optical zones after previous LASIK underwent topography-guided retreatment with the ALLEGRETTO WAVE. Sixteen keratoconus eyes underwent topographic neutralizing technique photorefractive keratectomy (PRK). The study assessed preoperative and 6-month and 1-year postoperative results regarding best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), topography, and predictability. RESULTS: Sixty-seven eyes with previously decentered optical zones had an improvement of centration from 0.92 mm preoperatively to 0.30 mm postoperatively relative to pupil center (P<.01). Twenty-nine percent of these eyes gained 1 or more lines of BSCVA, whereas 71% had no change in BSCVA. Forty-eight eyes with previously small optical zones had an increase of the central monodioptric optical zone from 3.9 mm to 5.6 mm (P<.01). Nineteen percent of eyes had an improvement of at least 1 line, whereas 75% had no change in BSCVA and 6% lost 1 line. Sixteen keratoconus eyes had custom topographic neutralizing technique PRK as an alternative to penetrating keratoplasty. All eyes had improvement of astigmatism up to 5.00 diopters (D), with a mean change of 1.68±1.62 D. Best spectacle-corrected visual acuity was unchanged in 8 (50%) eyes, with 4 (25%) eyes gaining 1 tine, 2 (12%) eyes gaining 2 lines, and 2 (12%) eyes losing 1 line of BSCVA at 6 months. CONCLUSIONS: Management of some highly aberrated eyes is now possible with topography-guided ablation using the WaveLight ALLEGRETTO platform and custom topographic neutralizing technique. Safety was acceptable for small optical zone and decentered ablation retreatments. The topography-guided ablation could be an alternative treatment for keratoconus patients if keratoplasty is otherwise indicated. The algorithms for custom topographic neutralizing technique need further refinement.

UR - http://www.scopus.com/inward/record.url?scp=42149191499&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=42149191499&partnerID=8YFLogxK

M3 - Article

C2 - 18500099

AN - SCOPUS:42149191499

VL - 24

SP - S439-S445

JO - Journal of Refractive Surgery

JF - Journal of Refractive Surgery

SN - 0883-0444

IS - 4

ER -