Effect of corneal epithelial remodeling on visual outcomes of topography-guided femtosecond LASIK. Journal of cataract and refractive surgery Saleh, S., Epp, L. J., Manche, E. E. 2022

Abstract

PURPOSE: To assess the effect of epithelial remodeling on visual outcomes over a 9 mm diameter corneal surface following topography-guided laser in-situ keratomileusis (LASIK) for myopia correction using spectral-domain anterior segment optical coherence tomography (AS-OCT).SETTING: Outpatient clinical practice at the Stanford University Byers Eye Institute in Palo Alto, California, USA.DESIGN: Prospective non-randomized observational study.METHODS: Visual acuity, including uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), 5% and 25% contrast sensitivity CDVA, manifest refraction and corneal epithelial thickness following topography-guided femtosecond LASIK were analyzed. Corneal epithelial thickness was mapped across 13 sections and 3 concentric zones using AS-OCT preoperatively and at 1, 3, 6 and 12 months postoperatively.RESULTS: Sixty eyes of 30 patients with a mean age of 32.8 years (range 23-52 ± 7.03 years) undergoing myopic LASIK correction were assessed. In eyes with complete follow-up data (n=30), mean preoperative UDVA was logMAR 1.48 ± 0.45 and logMAR -0.11 ± 0.08 at postoperative 12 months. Mean preoperative CDVA was logMAR -0.08 ± 0.11 and logMAR -0.13 ± 0.07 at 12 months. Linear mixed modeling demonstrated a significant correlation between improvement in UDVA and decreased superior and nasal corneal epithelial thickness as well as between improvement in CDVA and increased central epithelial thickness 12 months postoperatively.CONCLUSIONS: Improvement in UDVA and CDVA at 12 months following topography-guided femtosecond LASIK was correlated with non-uniform epithelial remodelling, including epithelial thickening in the central zone and thinning in the superior and nasal sections as measured by AS-OCT.

View details for DOI 10.1097/j.jcrs.0000000000000940

View details for PubMedID 35333817