This study evaluated 152 eyes of 105 patients that underwent advanced surface ablation (LASEK or Epi-LASEK) to treat extreme refractive errors. The authors found that 72% of eyes achieved 3-month postoperative uncorrected visual acuity equal or better than preoperative best corrected visual acuity, and this was maintained for at least one year. However, extremely hyperopic eyes were at greater risk of losing best corrected visual acuity postoperatively. The study demonstrates that advanced surface ablation can safely and effectively treat extreme prescriptions when combined with adjunctive treatments to prevent scarring, but further research is needed on outcomes for extremely hyperopic eyes.
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Advanced Surface Ablation for Extreme Prescriptions
1. Emil W. Chynn, MD
Sze H. Wong
Dorina Jaubelli
The authors have no financial interest LASEK or Epi-LASEK to treat extreme
in the subject matter of this poster. refractive errors
is not FDA-approved.
2. LASIK is not recommended for high
prescriptions because of compromised
visual outcomes1
Stromal bed thickness >250 microns to
avoid iatrogenic keratectasia2
PRK is prone to scarring for extreme
prescriptions3
Advanced Surface Ablation (LASEK/Epi-
3. To determine whether extreme prescriptions
may be safely and effectively treated with
Advanced Surface Ablation (ASA)
4. Adjunctive treatment to prevent scarring:
• Mitomycin C (MMC) 0.01% intraop
• Oral steroids: 1-3 wks postop
• Topical steroids: 2-6 mo postop
• Vitamin C: 2-6 mo postop
• UV protection: 3-12 mo postop
15. Extreme prescriptions may be safely and
effectively treated with advanced surface
ablation when combined with adjunctive
treatments to prevent scarring
72% eyes: 3-mo. postop UCVA ≥ preop
BCVA (maintained for at least one year)
Further studies are needed to determine
whether extremely hyperopic eyes are at
risk for loss of BCVA and how to avoid this
loss
16. 1. Knorz MC, Wiesinger B, Liermann A, Seiberth V, Liesenhoff H. Laser
in situ keratomileusis for moderate and high myopia and myopic
astigmatism. Ophthalmology. 1998;105:932-940.
2. Seiler T, Koufal K, Richter G. Iatrogenic keratectasia after laser in situ
keratomileusis. J Refract Surg. 1998;14:312-317.
3. Kremer I, Kaplan A, Novikov I, Blumenthal M. Patterns of late corneal
scarring after photorefractive keratectomy in high and severe myopia.
Ophthalmology. 1999;106:467-473.
4. Holladay JT. Proper method for calculating average visual acuity. J
Refract Surg. 1997;13:388-391.