ArticleEye and vision (London, England)2024
Nominal and achieved stromal ablation depth after myopic transepithelial photorefractive keratectomy: implications for residual stromal thickness calculation.
Article in Eye and vision (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe primary objective of this investigation was to compare the nominal central ablation depth with the achieved central corneal stromal ablation depth after StreamLight transepithelial photorefractive keratectomy (tPRK) for myopia with WaveLight® laser by Alcon Laboratories, TX, USA.
methodsThis ambispective study encompassed a retrospective analysis of 40 eyes who underwent treatment for myopia and astigmatism, followed by a prospective examination conducted 6-9 months postoperatively. Pre- and postoperative Avanti spectral-domain optical coherence tomography (SD-OCT; Optovue Inc., CA, USA) provided stromal and epithelial thickness maps. The difference between pre- and postoperative central stromal thicknesses at the corneal vertex was used to calculate the achieved stromal thickness ablation depth. This value was then compared with the corresponding central nominal depth on the laser ablation planning map.
resultsA total of 40 eyes (OD/OS:18/22) of 40 patients (31.4 ± 9.2 years) were available for evaluation. The mean treated spherical equivalent was - 2.98 ± 1.46 D. The mean nominal and achieved central stromal ablation depths were 51.22 µm and 59.67 μm, respectively, showing a mean stromal excessive ablation of 16.50%. The mean pre- and postoperative central epithelial thicknesses were 53.74 μm and 59.31 μm, respectively, showing a mean postoperative thickness increase of 10.46%. This increase in the epithelial thickness rendered the mean postoperative pachymetry reduction to 54.11 μm, only 2.33% greater than the mean nominal ablation depth.
conclusionsThe study revealed a central stromal ablation 16.50% greater than the nominal ablation depth. This excessive stromal removal was largely compensated for by the increase in epithelial thickness, resulting in a mean difference between the nominal ablation depth and the achieved central corneal pachymetry reduction of only 2.33%. This significant excessive central stromal ablation must be taken into consideration in the calculation of the residual stromal thickness.
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