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

• Published in: Clinical ophthalmology (Auckland, N.Z.) N.Z.), 2024-11, Vol.18, p.3125-3131
• Main Authors: Min, Ji Sang, Min, Byung Moo
• Format: Article
• Language: English
• Subjects: corneal remodeling; Keratoconus; keratoconus suspect; l-lak; Medical research; Medicine, Experimental; Methods; Short Report
• ISSN: 1177-5467; 1177-5483; 1177-5483
• DOI: 10.2147/OPTH.S486687

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