Topography-Guided Custom Ablation Treatment for Post-Traumatic Corneal Irregularities-Case Reports

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Post-traumatic corneal wounds requiring sutures are common, leading to reduced transparency, corneal distortion, astigmatism, and higher-order aberrations (HOAs).
• Excimer laser treatment presents a potential intervention for managing visual defects after corneal trauma.

Purpose of the Study:

• To evaluate the effectiveness of topography-guided custom ablation treatment (TCAT) as a second-stage intervention for corneal injuries.
• To assess the impact of TCAT on corneal surface regularity, astigmatism, and higher-order aberrations following trauma.

Main Methods:

• A cohort study involving four patients (three with penetrating and one with blunt corneal trauma) who underwent TCAT after initial wound stabilization.
• TCAT was performed with mitomycin C application to prevent haze, followed by measurements of uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BCVA), refractive astigmatism, topographic astigmatism, and higher-order aberrations (RMS).
• Corneal healing and refractive changes were monitored post-treatment.

Main Results:

• TCAT successfully regularized the corneal surface and reduced HOAs in all patients.
• Significant improvements in UDVA were observed, ranging from 3 to 7.5 lines on the Snellen chart.
• Resultant UDVA ranged from 0.7 to 1.2, and BCVA ranged from 1.0 to 1.5, indicating substantial visual recovery.

Conclusions:

• TCAT effectively regularized corneal surfaces and reduced HOAs in patients with post-traumatic corneal astigmatism.
• TCAT is a potentially beneficial second-stage treatment option for improving visual outcomes after corneal trauma.