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Elliptic Shaped LASEK Instruments to Enhance Astigmatic Correction in LASEK
Winkler von Mohrenfels C., Gabler B., Lohmann C.,
Universität Regensburg, Klinik und Poliklinik für Augenheilkunde (Regensburg)
Purpose: Commercially available LASEK instruments have a round design (8 to 9 mm diameter). As some laser systems make an elliptic ablation, which is in one direction near to the limbus, the stroma will not be ablated in this astigmatic axis. In fact, our results for astigmatic LASEK correction with such circular instruments were not very impressive. Therefore we have developed in cooperation with the firm Geuder new elliptic shaped LASEK instruments and we present our first result.
Methods: The new set consists of an elliptic (11x8mm) microtrepan with a 70 µm calibrated blade and an elliptic alcohol cone (11,5x8,5 mm). We have performed astigmatic LASEK in 60 eyes so far with astigmatism >1 D using the new astigmatic instruments, 20% ethanol for 20 seconds and the keracor 217 excimer laser (Chiron Technolas, USA). Maximum follow-up is now currently 12 months. Astigmatic outcome was analysed with vector analysis (Alpins 1983).
Results: The astigmatism was between -1,0 and -3,5 D (mean -1,69D SD 0,75D). The elliptic flap could be created in all eyes without any problems. The postoperative spheric refraction was between +0,75 and -0,75 D (mean -0,04 ±0,27 D) and the astigmatism was between 0 and -0,75 D (mean -0,27 SD 0,23). The mean index of success was 0,18 ( SD 0,15), which is a very good result.
Conclusions: Astigmatic LASEK with elliptic instruments is a safe and effective method for the treatment of astigmatism. It does not affect the spherical correction. Astigmatic LASEK seems to be superior to LASEK with round instrument.