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Topography-guided surface ablation for forme fruste keratoconus.

Tobias Koller1, Hans Peter Iseli, Christof Donitzky

  • 1Institut für Refraktive und Ophthalmochirurgie, Zurich, Switzerland.

Ophthalmology
|December 13, 2006
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Topography-guided customized surface ablation effectively improved vision and reduced visual distortions in patients with forme fruste keratoconus. This treatment offers a promising solution for contact lens-intolerant individuals.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Refractive Surgery

Background:

  • Forme fruste keratoconus presents challenges in visual rehabilitation, particularly for contact lens-intolerant patients.
  • Standard treatments may not fully address the irregular astigmatism and visual distortions associated with this condition.

Purpose of the Study:

  • To assess the efficacy of topography-guided customized surface ablation for treating forme fruste keratoconus.
  • To evaluate visual acuity, refractive error, and visual quality in affected eyes.

Main Methods:

  • A prospective case series involving 11 eyes of 8 contact lens-intolerant patients with forme fruste keratoconus.
  • Treatment involved topography-guided customized surface ablation using a scanning spot excimer laser.
  • Outcomes measured included visual acuity, refraction, ghosting, and corneal topography (Zernike parameter Z3).

Main Results:

  • Significant reductions in manifest refractive error (spherical equivalent by -2.8 D, cylinder by 1.34 D) and corneal irregularity (Z3 reduced by 41%).
  • All patients reported decreased ghosting, and 7 of 11 eyes gained at least one line of best spectacle-corrected visual acuity.
  • No eyes experienced a loss of best spectacle-corrected visual acuity.

Conclusions:

  • Topography-guided surface ablation is a viable and effective treatment for forme fruste keratoconus.
  • This refractive surgery approach shows promise in rehabilitating vision for contact lens-intolerant patients.
  • The procedure improves visual acuity and reduces visual aberrations in this specific patient group.