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Laser asymmetric ablation method to improve corneal shape.

José Alberto Rodríguez Agudo1, Jinyoung Park2,3, Jina Park3

  • 1Institute of Fluid Mechanics, University of Erlangen-Nuremberg, Campus Busan, Busan, Republic of Korea. jose.a.rodriguez@fau.de.

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|March 24, 2019
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Summary

Central-symmetric corneal thickness effectively reduces off-centered corneal shifts caused by intraocular pressure (IOP) after presbyopia correction. A 45° angled ablation pattern significantly improved visual outcomes and corneal reshaping.

Keywords:
Asymmetric corneal ablationCentral-symmetric corneal thicknessLaser asymmetric keratectomySemi-cylindrical ablation

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Refractive Surgery

Background:

  • Intraocular pressure (IOP) can induce off-centered corneal shifts, particularly after refractive surgery.
  • Presbyopia correction techniques aim to maintain or improve visual acuity across multiple distances.
  • Controlling corneal shape is crucial for predictable refractive outcomes.

Purpose of the Study:

  • To evaluate if central-symmetric corneal thickness can mitigate off-centered corneal shifts induced by IOP.
  • To compare the efficacy of two different asymmetric corneal ablation patterns in achieving central corneal symmetry.
  • To assess visual outcomes and corneal shape changes after peripheral presbyopia correction.

Main Methods:

  • Retrospective study of 122 healthy eyes from 62 presbyopic patients (mostly myopic).
  • Two groups received distinct asymmetric corneal ablations (90° vs. 45° angled combinations) for peripheral presbyopia correction.
  • Image processing algorithms analyzed pre- and postoperative corneal maps (Orbscan II) to determine central symmetry (f) and visual axis deviation (d).

Main Results:

  • Both groups achieved a target spherical equivalent of -1D with no significant difference in uncorrected distance visual acuity (UDVA).
  • Uncorrected near visual acuity (UNVA) was significantly better in the 45° group (group 2).
  • Group 2 demonstrated central-symmetric corneal thickness and posterior cone, with the posterior corneal apex relocating towards the visual axis (p<0.05).

Conclusions:

  • Asymmetric corneal ablation using a 45° angled combination can induce central-symmetric corneal thickness.
  • Intraocular pressure plays a significant role in reducing off-centered corneal shifts and reshaping the posterior corneal cone.
  • This technique offers a novel approach to control corneal shape and improve visual function in presbyopic patients.