Topography-Guided Excimer Laser Surgery: Indications and Techniques
Topography-guided (TG) excimer laser surgery has the potential to treat irregular astigmatism and may be of great utility when few other treatment options exist. This chapter will summarize the indications and a general treatment approach when using TG laser ablation for multiple causes of irregular astigmatism. Contemporary treatment platforms have also revolutionized this treatment modality, and we view this as an ongoing area of advancement in laser refractive surgery. Customized treatment profiles which compensate for induced refractive changes that occur during normalization of an irregular cornea are improving patient outcomes. This chapter discusses our and other clinician’s outcomes with using TG phototherapeutic refractive keratectomy (PRK) to treat astigmatism occurring in grafted corneas, ectasias, post-refractive patients, and other causes of irregular astigmatism. Corneal collagen cross-linking (CXL) in conjunction with TG PRK is proving successful in treating ectatic corneal disease, and we share our experience with these combined treatment modalities.
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