September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Topography-Guided Custom Ablation for Optical Zone Enlargement and Recentration after Previous Myopic LASIK
Author Affiliations & Notes
  • Timothy J Archer
    London Vision Clinic, London, United Kingdom
  • Dan Z Reinstein
    London Vision Clinic, London, United Kingdom
    Columbia University Medical Center, New York, New York, United States
  • Marine Gobbe
    London Vision Clinic, London, United Kingdom
  • Alastair J Stuart
    King's College Hospital, London, United Kingdom
  • Eleanor A Miller
    London Vision Clinic, London, United Kingdom
  • Glenn Carp
    London Vision Clinic, London, United Kingdom
  • Footnotes
    Commercial Relationships   Timothy Archer, None; Dan Reinstein, ArcScan Inc (I), ArcScan Inc (P), Carl Zeiss Meditec (C), Carl Zeiss Meditec (P); Marine Gobbe, None; Alastair Stuart, None; Eleanor Miller, None; Glenn Carp, Carl Zeiss Meditec (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4878. doi:
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    • Get Citation

      Timothy J Archer, Dan Z Reinstein, Marine Gobbe, Alastair J Stuart, Eleanor A Miller, Glenn Carp; Topography-Guided Custom Ablation for Optical Zone Enlargement and Recentration after Previous Myopic LASIK. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4878.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Report the results of optical zone enlargement and recentration using topography-guided ablation after previous myopic LASIK.

Methods : Retrospective analysis of 73 eyes that underwent a topography-guided retreatment for optical zone enlargement or recentration after primary myopic LASIK with the MEL80. Atlas corneal topography, corneal wavefront and manifest refraction were used to generate the ablation profile using the CRS-Master and MEL80 excimer laser. Refractive and visual outcomes were analysed. Optical zone centration and diameter were assessed by electronically overlaying a set of paracentral rings and central grid onto tangential curvature difference maps, with the edge of the optical zone identified as the mid-peripheral power inflection point. The change in corneal spherical aberration was also calculated. Follow-up was 3 to 12 months.

Results : SEQ was -0.54±0.99 D (-3.75 to +1.00 D) after the primary LASIK and -0.21±0.63 D (-1.88 to +2.25 D) after the topography-guided retreatment, with 71% within ±0.50 D and 92% within ±1.00 D of the intended target SEQ. UDVA after the retreatment (vs CDVA before retreatment) was 20/20 or better in 82% (91%) and 20/25 or better in 93% (92%) of eyes. No eyes lost 2 lines CDVA, and contrast sensitivity was normal and unchanged. Optical zone decentration from the corneal vertex was reduced by 63% from 0.58±0.26 mm (0.05 to 1.28 mm) to 0.21±0.14 mm (0.00 to 0.54 mm). Optical zone diameter was increased by 11% from 5.65±0.52 mm (4.8 to 7.0 mm) to 6.33±0.52 mm (5.0 to 7.6 mm). Corneal spherical aberration was reduced by 46%, coma was reduced by 49%, and higher order RMS was reduced by 39%.

Conclusions : Topography-guided custom ablation is an effective treatment for decentrations and optical zone enlargement. Refractive accuracy was similar to standard LASIK retreatments.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.


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