Corneal Remodeling Using Laser Asymmetric Keratectomy in Patients with Keratoconus Suspect

Background: The aim of this study was to assess a corneal remodeling technique using laser asymmetric keratectomy (C-LAK) treatment, and its outcome for keratoconus suspect (KCS) by evaluating corneal regularity. Methods: In this retrospective case-control study, 34 eyes of 20 patients with KCS were studied before and 1 year after L-LAK. This new technique could ablate the original refractive errors, the thicker peripheral cornea, and myopia induced by LAK simultaneously (crescentic customized ablation). Before and 1 year after the operation, the refraction, UDVA, keratometry, and corneal symmetry evaluated as the total corneal central-thickness deviation (SUM) and the distance between the maximum posterior elevation (best-fit-sphere [BFS]) and the visual axis (DISTANCE) were compared. Results: Twenty patients with KCS aged 41.0 ± 13.5 years were evaluated. Preoperatively, the spherical equivalent (SE, D) -2.57 ± 1.64 and the Kmax was +48.21 ± 0.89 D. At 1 year postoperation, 79.4% (27/34) of the eyes had a UDVA of 20/20 or better. The SE and Kmax (D) were -0.40 ± 0.43, 44.47 ± 1.38 (Ps = 0.001, respectively), the corneal symmetry was better due to the decrease in the SUM (µm) (from 141.88 ± 48.24 to 66.21 ± 15.22) and DISTANCE (mm) (from 1.11 ± 1.14 to 0.46 ± 0.40). No postoperative corneal ectasia appeared. Conclusions: L-LAK made the corneas symmetric by decreasing the SUM and DISTANCE, decreased focal steepening, and showed good 1-year postoperative outcomes.