April 26, 2025
1 min learn
Key takeaways:
- Topography-guided laser imaginative and prescient correction presents a number of advantages for sufferers with irregular astigmatism.
- The process is just not depending on pupil dimension and could be measured reproducibly.
LOS ANGELES — Topography-guided laser imaginative and prescient correction presents a number of advantages: It’s not depending on pupil dimension, could be measured reproducibly and isn’t influenced by vitreous opacities, based on a speaker.
Throughout Refractive Day on the American Society of Cataract and Refractive Surgical procedure assembly, Karl G. Stonecipher, MD, supplied an outline of and basic recommendation for topography-guided excimer laser ablation in sufferers with irregular astigmatism.
Picture: Eamon N. Dreisbach
Topography-guided laser imaginative and prescient correction presents a substitute for right higher-order refractive errors, he stated. Prime candidates embody sufferers with uneven astigmatism, corneal decentrations, central islands, post-penetrating keratoplasty corneal scarring or earlier corneal cross-linking.
There are a number of protocols out there for topography-guided laser imaginative and prescient correction, he stated.
“For probably the most half, you discover one, follow it, nomogram it as finest as you’ll be able to after which work by means of the method,” he stated.
Stonecipher’s most popular technique for topography-guided excimer ablation is to make use of –4 D with the WaveLight laser (Alcon) to take away 60 µm of epithelium and “then go on and divide that up and make a topographic remedy after that.”
Small aperture lenses also needs to be thought-about.
“Folks have lens adjustments, so go do a cataract process to place in an IC-8, or an Apthera, lens (Bausch + Lomb),” he stated. In post-LASIK sufferers, “for those who’re going to take away the epithelium, attempt to discover the surgeon that did the preliminary surgical procedure.”
If custom-made remedy is critical, the epithelium could be eliminated with alcohol, or a transepithelial method can be utilized.
Contact lens trials could be helpful in sufferers with irregular corneas, Stonecipher stated, utilizing astigmatic lenses.
“Try to see what the sufferers want, what they like and what they will put on, and you can be stunned at how that helps you with outcomes,” he stated.
Sources/Disclosures
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Stonecipher KG. Treating irregular astigmatism with topography guided excimer ablation. Offered at: American Society of Cataract and Refractive Surgical procedure assembly; April 25-28, 2025; Los Angeles.
Disclosures:
Stonecipher reviews having monetary disclosures for Alcon, Allergan/AbbVie, Alphaeon, Attia Imaginative and prescient, Bausch Well being, Blink Vitality, CSI, Dompe, Espansione, Eyevance Prescription drugs, EyePoint Prescription drugs, Johnson & Johnson, Presbia, Rayner, STAAR Surgical, Floor and Tarsus.
