Custom phototherapeutic keratectomy with intraoperative topography

Paolo Vinciguerra, Fabrizio I. Camesasca

Research output: Contribution to journalArticlepeer-review


PURPOSE: Treatment of highly aberrated eyes with opacities or irregularities consequent to previous refractive treatment, ulcers, keratitis, trauma, or corneal dystrophies remains a challenge for refractive surgeons. We evaluated the results of custom phototherapeutic keratectomy (CPK) with intraoperative corneal topography-based aberrometry and custom ablation in highly aberrated eyes. METHODS: We prospectively evaluated eyes undergoing custom phototherapeutic keratectomy (CPK) with custom ablation for corneal opacities and/or irregularities due to previous refractive treatment, keratitis, trauma, or dystrophies. Customization was planned according to corneal topography-based aberrometry, performed intraoperatively after removal of corneal epithelium. RESULTS: We treated 35 eyes of 34 patients. Mean preoperative haze was 1.6 ± 1.4 in eyes with previous refractive surgery. Mean preoperative pachymetry was 425.7 ± 119.3 pm. Mean preoperative spherical equivalent refraction was -1.60 ± 3.65 D ranging from -9.38 to +10.00 D. No eye reached 20/15 best spectacle-corrected visual acuity (BSCVA), and only 63% could see 20/30 BSCVA. At final 6-month examination, mean spherical equivalent refraction was -0.71 ± 4.01 D, ranging from -11.25 to +5.25 D. All eyes reached 20/30 or better BSCVA, and 19% had 20/15 or better BSCVA. CONCLUSIONS: Intraoperative, epithelium-free topography-based corneal aberrometry proved to be a feasible option for custom ablation in highly aberrated eyes. This approach widens the applications of PTK, providing a new procedure, custom PTK, that can be a successful solution for eyes that would otherwise require penetrating keratoplasty.

Original languageEnglish
JournalJournal of Refractive Surgery
Issue number5
Publication statusPublished - Sep 2004

ASJC Scopus subject areas

  • Ophthalmology


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