ASCRS SYMPOSIA
20/30 and BCVA of 20/20 in the
right eye and uncorrected vision
of 20/25 and BCVA of 20/15 in
the left eye.
He was kept on steroids for
a year postop. At 1 year, he had
continued to improve to 20/20
uncorrected vision in the right eye.
The results echoed the finding
of a 2001 study in the journal
Ophthalmology, which found dense
haze and vision deterioration in
most of a group of highly myopic
patients who received PRK with-
out MMC.
"It has become essential to
use MMC if you are performing
PRK enhancements over LASIK,"
Dr. Pineda said.
Dr. Pineda also noted that
using anterior segment imaging
can be helpful in diagnosing and
managing corneal complications
from refractive surgery.
Another presentation at the
Symposium of Challenging Cases
examined usual results from a pa-
tient treated with Contoura Vision
(Alcon), the first personalized to-
pography-guided LASIK platform
approved by the U.S. FDA.
Parag Majmudar, MD,
Chicago, noted the system was
developed to correct higher-or-
der aberrations through corneal
topography.
A 31-year-old man underwent
uncomplicated LASIK in both
eyes but several months after
developed monocular diplopia
in the right eye. His uncorrected
vision was 20/30 with significantly
reduced quality of vision.
The patient's largest challenge
was a large drop-off of the homo-
geneity of the central 3 mm of the
cornea.
In response, Dr. Majmudar
lifted his flap and performed
topography-guided ablation. The
result was significantly improved
topography but the patient viewed
his vision as significantly worse
because he developed more myo-
pic refractive error. It turned out
that the pattern used to address
higher-order aberrations was a
hyperopic ablation, which induces
myopia.
Dr. Majmudar performed a
second topography-guided treat-
ment and his vision improved to
20/20 but he remained somewhat
unhappy due to lingering aberra-
tions.
In response, Dr. Majmudar
has begun testing new software,
which aims to perform all of the
complex analyses to "get an idea
what we exactly are treating and
how much residual will there be,
and it comes up with a very simple
plan for you to follow."
Editors' note: Drs. Pineda and Ma-
jmudar have financial interests with a
number of ophthalmic companies.
Nextech
37
continued from page 36
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