Circumferential anterior- and posterior-based wedge keratectomies: novel refractive procedures

Wedge resections have been demonstrated to have significant effects on the curvature of the cornea in the meridian of the resection. This paper describes two complimentary, noninvasive, circumferential wedge keratectomy techniques for the correction of spherical ametropia. Eleven eye bank eyes were studied. Four eyes underwent the circumferential anterior-based wedge (ABW) keratectomy technique in an attempt to induce steepening of the cornea. Seven eyes underwent the circumferential posterior-based wedge (PBW) keratectomy in an attempt to flatten the cornea. The mean steepening of 4.86 +/- 1.79 diopters in the ABW group was statistically significant (p less than 0.01). The mean flattening of 7.47 +/- 4.46 diopters in the PBW group was also found to be significant (p less than 0.01). These techniques are presented as viable alternatives to relaxing incision techniques such as radial keratotomy. Further refinement of the technique and improved technology will make these techniques more predictable and reliable.