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NR. 3(I)/2004
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Refractive surgery
after previous optical surgery procedures
Iwona Liberek1, Jerzy
Szaflik1,2
1LASER Eye Microsurgery Centre in Warsaw
2Department of Ophthalmology Medical University of
Warsaw
Head: Jerzy Szaflik, MD, PhD |
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| Summary: |
Obtained results indicate
that TOSCA system enables to obtain good results in the
majority of cases of irregular astigmatism related to
previous surgery. The use of TOSCA system enables total
reduction of glare and double vision and in most cases
increases the vision quality. Laser treatment is a
widely used and predictable method of correcting
refractive errors (2,5,6). Unfortunately, in some cases
it results in irregular astigmatism.(7,8) We deal with
cases of irregular astigmatism also after previous
ophthalmic procedures such as e.g. penetrating
keratoplasty, extracapsular cataract extraction, radial
keratotomy etc. Asymmetric astigmatism develops also in
the process of haze-forming cornea injuries. These types
of complications cannot be treated with standard
ablation methods using baseline algorithms (1,9,10,11)
which do not allow for customised reshaping of the
cornea. The use of cornea topography to perform the
procedure provides for customised ablation. The aim of
refractive surgery after previous ophthalmic procedures
is to eliminate the residual errors and, in complex
cases, reduce the errors so that appropriate eyeglasses
can be selected.
The type and performance time of the correction depends
on what procedure was performed earlier.
The aim of our research has been to evaluate
effectiveness and safety of topography-assisted cornea
reshaping in treatment of irregular astigmatism
developed after previous ophthalmic operations and also
to apply this procedure to correct errors developed
after lens implantation.
Materials and methods: At the LASER Eye
Microsurgery Centre in Warsaw, we performed 176
irregular astigmatism correction procedures between
January 2002 and July 2004. The group covered by the
research included 58 female and 46 male patients at an
average age of 27 ± 4.2 (it ranged from 21 and 64 years)
Patients qualified for TOSCA procedures included those
with astigmatism developed after previous radial
keratotomy (9 eyes), penetrating keratoplasty (12 eyes),
extracapsular cataract extraction (25 eyes), with
decentration after LASIK/LASEK/PRK (9 eyes), patients
after previous phakic lens implantation (17 eyes) and
patients with primary irregular astigmatism (104 eyes).
The analysis covered only cases of astigmatism
correction after previous ophthalmic procedures (72 eyes). |
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| Key words: |
Topography Supported
Customised Ablation, customised ablation, irregular
astigmatism. |
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