A Novel Corneal Remodeling Technique of Laser Asymmetric Keratectomy in Keratoconus Suspect: A Retrospective Case Control Study

Abstract

Purpose: This retrospective case control study report includes 4 eyes of 4 patients (aged from 37 to 44 years) with keratoconus suspect (KCS) who underwent laser epithelial keratomileusis linked laser asymmetric keratectomy (L-LAK) as corneal remodeling technique in order to avoid postoperative corneal ectasia.

Patients and methods: Four eyes of 4 patients showed corneal topography findings with abnormal localized steep keratometric curvature greater than 47.0 D and peripheral corneal thickness asymmetry (Total corneal central thickness deviations in four directions on Orbscan map (SUM)≥80 µm). L-LAK could be performed both the original ablation of refractive errors (SE from -1.25 to -5.50 D) and the customized ablation (selective ablation of the thicker peripheral cornea averaging:64 µm selectively and the central cornea of the myopic shift due to LAK averaging-1.50D. The main outcome measures between preoperative and postoperative 2 year were refraction, visual acuity (UDVA), keratometry, corneal symmetry evaluating SUM.

Results: After 2 years, SEs (D, average) were -0.34, UDVA (LogMAR) was 0.00. keratometry including Kmax was markedly decreased, SUM had diminished markedly. There were no case of postoperative adverse effects.

Conclusion: L-LAK resulted in a decreased SUM, increased corneal symmetry, and no postoperative corneal ectasia with good visual outcomes in myopic patients with KCS.