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J. P. Handler, M. H. Manning, Jr., K. F. Johnson, R. M. Davis; Analysis of the Efficacy, Predictability, and Safety of Custom Lasek for the Treatment of Refractive Error in Patients with Mild Abnormalities in Corneal Topography Using the Allegretto Wave Excimer Laser. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5353.
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To evaluate the efficacy, predictability, and safety of laser-assisted subepithelial keratectomy (LASEK) for the treatment of myopia and hyperopia with or without astigmatism in eyes with mild abnormalities in preoperative corneal topography characterized as having either posterior elevation >40µm, inferior or superior steepening, or skewed radial axis of deviation.
This retrospective analysis comprised 21 eyes that had custom LASEK for refractive error using the Allegretto Wave excimer laser. Primary outcome variables including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and complications were evaluated at 1 and 3 months. Preoperative higher order aberrations measured by Zywave Root Mean Squared (RMS) were also evaluated.
The mean spherical equivalent for the treatment of hyperopia was +1.52 diopters (D) ± 0.75 preoperatively, -1.22 ± 1.33 D at 1 month, and -0.73 ± 1.22 D at 3 months, reflecting 7 patients treated for emmetropia and 6 patients treated for near vision. The mean spherical equivalent for the treatment of myopia was -2.58 diopters (D) ± 1.27 preoperatively, -0.39 ± 0.69 D at 1 month, and -0.08 ± 0.33 D at 3 months including one patient treated for near vision. Mean preoperative RMS values were 0.31µm ± 0.14 at the 5mm and 0.54µm ± 0.23 at the 6mm zone. At 1 and 3 months, the UCVA was 20/25 or better in 86% and 94% of eyes, respectively. All treated eyes achieved an UCVA of 20/40 or better at 1 and 3 months. A target spherical equivalent was achieved within ± 0.5 D in 81% and 75% of eyes respectively and within ± 1.0 D in 100% of treated eyes. No eye lost more than 2 lines of BSCVA. At 1 and 3 months, no eyes had any evidence of corneal haze or ectasia.
Laser-assisted subepithelial keratectomy with the Allegretto Wave was an effective, predictable, and safe procedure for the treatment of refractive error in patients with mild abnormalities in corneal topography. Further studies are needed to determine the long-term stability of these results.
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