1Dick H. B., 2Förster W., 3Anschütz T., 4Goes F., 5Dausch D., 6Pallikaris I., Pietilä J., Verges C.

1Augenklinik, Johannes-Gutenberg-Universität, Mainz; 2Augenzentrum Prof. Zirm, Innsbruck; 3Laser-Zentrum, Gaggenau; 4Laserklinik, Antwerpen; 5Augenarztpraxis, Amberg; 6Laserzentrum, Athen

Purpose: Evaluation of customized re-treatments after PRK and LASIK from both the clinician's and the patient's view. The study is based on visual acuities, topographies and a subjective poll.
Methods: Up to now some 223 eyes were measured postoperatively using various topography machines (Orbscan II, TMS 3, C-Scan). All subjects complained about halos, glare and other photic phenomena after previous surgery. The asymmetric pictures were transformed into address fields by a conversion program (TOSCA). These address fields are processed by an excimer laser (MEL 70 G-Scan, Asclepion) onto the cornea. After the treatment we determined not only refraction and visual acuity but also the subjective impression of the patients.
Results: About ¾ of the eyes stayed within +/- 1 line BCVA, only in single cases we found a loss of more than two lines. All other eyes gained 2 lines or more. Besides these objective measurements we detected more than 50% of the patients realizing an improvement of visual comfort (disappearing of diplopia, halos etc.). 40% reported small or no changes and less than 5% remained unhappy.
Conclusions: The results demonstrated that through address fields calculated by TOSCA, which are applied using an excimer laser, it is possible to yield an alleviation of subjective complaints in many cases. What seems to be most important, is a complete anamnesis to be able to evaluate the images comprehensively. More treatments on a greater number of eyes are necessary before drpping a final conclusion.

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