Topography-guided photo refractive keratectomy for dysphotopsia - - PowerPoint PPT Presentation

Topography-guided photo refractive keratectomy for dysphotopsia after small incision lenticule extraction

Emrullah TASINDI, MD, Prof. Okan University, Faculty of Medicine, Ophthalmology Departement

Purpose

• To report the outcome of topography guided photorefractive

keratectomy (PRK) in a case with dysphotopsic problems secondary to decentered lenticule extraction after small incision lenticule extraction (SMILE).

Case

• 28 year-old woman
• Dysphotopsic problems as ghost images, halo

and glare 2 years after SMILE surgery

• Astigmatism and decentered ablation in both

eyes inducing an increase in high order aberrations, coma and spherical aberration.

Case

• Pre op Rx:

– OD: -1,25 x 175 – OS:-0,75 x 165

• Visual acuity: (CDVA)

– OD: 0.4 – OS: 0.8

Case

• Bilateral Topography-guided PRK with 0.02%

Mitomycine C was performed.

• Three months after re-treatment, uncorrected

(UDVA) and corrected (CDVA) distance visual acuity, HOA, spherical aberration and coma were evaluated.

Results

• Subjective symptoms of the

patient were diminished

• UDVA increased from 0.3 to

0.8 in OD and from 0.6 to 0.8 in OS

• CDVA increased from 0.4

to 0.8 in OD and from 0.8 to 0.9 in OS.

Results

• Corneal aberrations

were improved

Results

• There was no haze

development in the follow up period.

Conclusion

• Decentered treatment is not an uncommon

complication after corneal refractive surgery.

• It plays a major role in the induction of higher-
• rder aberrations.
• Topography-guided PRK treatment may reduce

visual symptoms and increase visual acuity and quality after decentered lenticule extraction.

Thank you….