Department of Cornea and Refractive surgery, Narayana Nethralaya, Bangalore, India.
Shroff Eye Centre, New Delhi, India.
Eur J Ophthalmol. 2021 May;31(3):1437-1443. doi: 10.1177/1120672120945907. Epub 2020 Jul 24.
To report a case of management of a post-LASIK superficial corneal scar using a novel single-step topography-based customized phototherapeutic keratectomy (PTK).
Surgical technique description.
Ablation was planned using Schwind Amaris 1050RS excimer laser as decentered trans-epithelial PTK of 5 mm × 3.5 mm of 75 µm depth exactly over the area of the scar. UDVA, CDVA improved from 20/60 and 20/40 pre-operatively to 20/30 and 20/20p post-operatively. Refractive error improved from -2.5 DC @135 to +0.25 DS/-0.25 DC @75. Regularization of topography and stromal surface on ASOCT was noted with minimal hyperopic shift. Another step of ablation to address induced hyperopia was not required.
Topography-based customized PTK appears to be an effective novel technique for the management of superficial corneal scars with minimal induced refractive change. This technique holds promise as an alternative in the targeted management of superficial corneal scars, traditionally treated by conventional PTK, without significant ablation of normal tissue.
报告一例使用新型单点基于地形图定制光性角膜切削术（PTK）治疗 LASIK 后浅层角膜瘢痕的病例。
手术技术描述。
使用 Schwind Amaris 1050RS 准分子激光进行偏心性经上皮 PTK，光斑大小为 5mm×3.5mm，深度为 75μm，正好覆盖在瘢痕区域。术后最佳未矫正视力（UDVA）、最佳矫正视力（CDVA）从术前的 20/60 和 20/40 提高到 20/30 和 20/20p。术后等效球镜（REF）从 -2.5DC@135 改善至+0.25DS/-0.25DC@75。ASOCT 上观察到地形图和基质表面规则化，且没有明显的远视漂移。不需要进行另一次消融以解决诱导性远视。
基于地形图的定制 PTK 似乎是治疗浅层角膜瘢痕的一种有效新技术，可使诱导的屈光变化最小化。这种技术有希望作为传统 PTK 治疗的浅层角膜瘢痕的替代治疗方法，而不会对正常组织造成明显消融。
