Original Article

Outcomes of Refractive Surgery in Patients With Topographic Superior Corneal Steepening

George D. Kymionis, MD, PhD; Vardhaman P. Kankariya, MD; Michael A. Grentzelos, MD; Vasilios F. Diakonis, MD; George A. Kounis, PhD; Evangelos Minos, MD; Jorge L. Alió, MD, PhD; Ioannis G. Pallikaris, MD, PhD

  • Journal of Refractive Surgery
  • July 2012 - Volume 28 · Issue 7: 462-467
  • DOI: 10.3928/1081597X-20120522-01
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Abstract

PURPOSE:

To evaluate the outcomes of refractive surgery in patients with topographic superior corneal steepening.

METHODS:

This retrospective, noncomparative, interventional, clinical study included 16 patients (29 eyes) with persistent superior corneal steepening as a variation of corneal curvature (inferior to superior topographic corneal difference of at least 1.00 diopter [D] at a 3-mm zone) not related to any underlying disease or condition who underwent corneal refractive surgery. Refractive, keratometric, and visual outcomes were evaluated preoperatively and at 1, 3, 6, 12, and 24 months postoperatively.

RESULTS:

Twenty-two eyes underwent photorefractive keratectomy and 7 eyes underwent LASIK. Mean follow-up was 27.38±2.37 months (range: 25 to 32 months). Mean preoperative inferior to superior keratometric difference was 1.61±0.36 D (range: 1.20 to 2.63 D). Mean preoperative spherical equivalent refraction was −4.45±1.66 D (range: −2.25 to −8.00 D), which decreased to −0.09±0.61 D (range: +0.75 to −1.38 D) (P<.05) at last follow-up. Mean preoperative topographic corneal astigmatism was 1.44±0.79 D (range: 0.52 to 3.83 D), which decreased to 0.66±0.39 D (P<.05) 3 months postoperatively and remained stable during follow-up (P<.54). Mean preoperative uncorrected distance visual acuity and corrected distance visual acuity in logMAR units were 1.57±0.62 and 0.02±0.06, respectively, which improved at last follow-up to 0.00±0.05 and −0.02±0.04, respectively. No intra- or postoperative complications were noted; specifically, no patients developed postoperative ectasia.

CONCLUSIONS:

Corneal refractive surgery in patients with isolated topographic superior corneal steepening provided acceptable refractive and visual outcomes without any intra- or postoperative complications. Diligence is required to screen for the potential of ectatic corneal disorders in this population. Photorefractive keratectomy may be a safer option for these patients than LASIK.

AUTHORS

From the Institute of Vision and Optics, Faculty of Medicine, University of Crete, Greece (Kymionis, Kankariya, Grentzelos, Diakonis, Kounis, Minos, Pallikaris); and Vissum/Instituto Oftalmológico de Alicante and Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain (Alió).

The authors have no financial or proprietary interest in the materials presented herein.

Correspondence: George D. Kymionis, MD, PhD, University of Crete, Faculty of Medicine, Institute of Vision and Optics (IVO), 71003 Heraklion, Crete, Greece. Tel: 30 281 037 1800; Fax: 30 281 039 4653; E-mail: kymionis@med.uoc.gr

Received: September 29, 2011
Accepted: May 04, 2012
Posted Online: June 18, 2012

doi: 10.3928/1081597X-20120522-01

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