Topography-guided transepithelial photoablation for the treatment of interstitial keratitis sequelae

Topography-guided transepithelial photoablation using the Wavelight Allegretto excimer laser was performed in a patient whose corrected distance visual acuity (CDVA) was severely impaired by superficial fibrosis and major irregular corneal astigmatism. One month postoperatively, the CDVA had improved from 20/400 to 20/50 with spectacle correction and 20/25 with a rigid gas-permeable contact lens. Postoperative corneal topography showed a substantial reduction in the irregular component of the astigmatism. Optical coherence tomography analysis revealed a major decrease in the central fibrotic scarring around the corneal visual axis. No complication occurred, and the patient was very satisfied. Topography-guided custom ablation seems to be a safe and efficient technique for reduction of the irregular component of corneal astigmatism in a scarred cornea. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.