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Topography-guided therapy best for irregular corneas


Washington, DC—Topography-guided ablation (T-CAT) using the Allegretto Wave Eye-Q excimer laser (WaveLight Laser Technologie AG) offers a safe and effective primary or secondary treatment method for achieving excellent outcomes in challenging cases, said Paul H. Hughes, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

T-CAT is performed by linking data acquired with the Allegro Topolyser to ablation with the advanced Allegretto Wave Eye-Q. The applications for this surgery include primary treatment in eyes with asymmetrical astigmatism or corneal scars, as well as in hyperopic eyes in which a decentered angle kappa may make it difficult to achieve good results with conventional ablation. In addition, T-CAT is proving very useful in complex re-treatments for eyes with decentration, small optical zones, or irregular ablations after previous excimer laser surgery, as well as in those with vision problems associated with irregular astigmatism or post prior surgery with penetrating keratoplasty (PKP) or RK, said Dr. Hughes, medical director, Southline Eye Centre, Sydney, Australia.

Dr. Hughes illustrated use of the T-CAT software and the outcomes achieved with a series of case examples, including treatment of asymmetrical astigmatism, small optical zone with or without decentered ablation, and post-PKP.

"It has been an absolute delight to treat patients who are suffering with visual symptoms after prior surgeries because we have been able to improve their quality of vision greatly, and these patients are ecstatic and grateful," Dr. Hughes said.

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