Table of Contents - WOC 2012

FP-REF-TH 08 (7)
Ectasia Risk Scores of Cancelled Patients in an Academic Refractive
Surgery Clinic
Hashemi Hassan (1,2) , Mohammadpour Mehrdad (1) , Jabbarvand Behrooz
Mahmood (1) , Khosravi Keivan (1)
1. Tehran University of Medical Sciences
2. Noor Eye Hospital and Research Center
Purpose: To evaluate causes of cancelling ablative refractive surgery regarding
Randleman Ectasia Risk Scores.
Methods: Ectasia risk scores were assessed for 194 eyes (97 cases). Patients
with moderate risk score were postponed for future follow up in next year and
those with high risk scores were cancelled.
Result: Mean ectasia risk score was 4.5 ± 2.67. 40 eyes (20.6%) had low risk
(0-2), 46 eyes (23.7%) had moderate risk (3) and 108 eyes (55.7%) had high
risk scores (4 or more). Regarding topographic characteristics, symmetrical
pattern was 65 (33.51%), asymmetrical bow tie was seen in 87(44.84%),
inferior steepening or a skewed radial axis in 39 (20.1%) and abnormal
topography was seen in 3 (1.54%). Mean central corneal thickness (CCT) was
520 microns, and mean estimated residual stromal bed thickness (RSB) was
312.38 microns. Low risk eyes had other cause of canceling including unstable
refraction during last year.
Conclusion: Randleman Ectasia Risk Score is a valuable modality in
preoperative decision planning procedure. Other risk factors for ablative
refractive surgery, such as unstable refraction, should be considered as an
independent risk score.
FP-REF-TH 08 (8)
Retrospective Analysis of Ectasia After Refractive Surgery in 12.000
Procedures
Gaviria Juan G. (1) , Arbelaez Maria Clara (1) , Mora Edna (1) , Sekito Dita (1) ,
Victoria Dario (1)
1. Muscat Eye Laser Center
Purpose: To determine the incidence of post-refractive surgery ectasia during
December 2007 until February 2011 at the Muscat Eye Laser Center in cases
with at least 3 months of follow-up and to detect common characteristics in
these cases in order to improve selection criteria.
Methods: A retrospective analysis of all LASIK, Femto-LASIK and LASEK
cases treated with the Schwind Amaris, the Carriazo Pendular and the Ziemer
LDV Platform, was conducted in search for cases that were diagnosed with
keratectasia. The diagnosis of keratectasia was performed by an expert
surgeon (M.C.A), based on topographic, elevation maps, and clinical criteria.
Results: Since December 2007 until February 2011, a total of 6582 eyes had
LASIK, 3380 had Femtosecond Assisted LASIK, 1916 eyes had LASEK and
39 had PRK (For a total of 11917). 8 eyes of 6 patients were determined to
have ectasia and treated with corneal collagen crosslinking. Retrospectively,
relevant findings in eyes with postoperative ectasia are described.
Conclusions: In a high-volume practice, the incidence of post-LASIK ectasia
was 0.0671% during the years 2007 to 2011. Retrospectively, some relevant
findings presumably associated with the risk of ectasia, are presented in this
series.
WOC2012 Abstract Book
FP-REF-TH 08 (9)
Diagnostic and Prognostic Factors in Post-Lasik Ectasia: A 108 Case
Study
Alio Jorge (1,2) , Brenner Luis (1) , Vega-Estrada Alfredo (1) , Cobo Rosario (3)
1. Vissum Corporation
2. Division of Ophthalmology, Universidad Miguel Hernandez
3. Clinica Baviera
Purpose: To evaluate the clinical features of post-Lasik ectasia taking into
consideration preoperative, intraoperative and postoperative data and to
define a grading system based on visual limitation.
Methods: Observational retrospective study for severity characterization of
post-Lasik ectasia. Multifactorial analysis for characterizing the relationship
between visual limitation and clinical data were performed. A post-Lasik grade
system is proposed based on the findings.
Results: One hundred eight eyes (55% men, mean age of 31,4±8,76 years)
with the diagnostic of post-Lasik ectasia were evaluated. The mean time for
diagnostic was 4,5±3,2 years (8 weeks to 17,8 years) and bilaterality was
present in 28% of the cases. Thirty percent of the cases presented corrected
distance visual acuity (CDVA) better than 0,05 LogMAR and 22% presented
CDVA worse than 0,40 LogMAR. Clinical data correlated to worse prognosis
were: preoperative spherical equivalent (-7,15±3,39D), preoperative internal
astigmatism (-1,21±1,61D), total ablation depth (122 ± 31 micra), surgical
induced astigmatism (-3,17±2,63D) and ectatic sphere (-4,42±4,53D).
Conclusions: Post-Lasik ectasia visual limitation can be explained by a
combination of severity defined parameters. Based on the results obtained, a
post-Lasik grade system is proposed.
FP-REF-TH 08 (10)
Results of Thin Flap Lase in Situ Keratomeleusis (LASIK) Created by
a Femtosecond Laser to Correct High Refractive Error After Corneal
Graft
Ghoreishi Mohammad (1)
1. Associated Professor, Isfahan University of Medical Scieces
Purpose: To evaluate visual outcomes and safety of thin LASIK using
femtosecond Laser to correct high ametropia after corneal graft.
Methods: In this study, 35 eyes of 31 patients who had undergone thin-flap
Lasik due to high refractive error after corneal grafting were evaluated. After
complete ocular examination and assessment of uncorrected and corrected
distant visual acuity (UDVA and CDVA), the patients underwent Femto-Lasik
using Ziemer Femto- LDV with 100 micron flap thickness.
Results: After 3 to 20 months follow-up, mean of LogMAR of UDVA increased
from 1.5 preoperatively to 0.3 postoperatively (P