Treatment of Highly Aberrated Eyes Using the NIDEK CXIII Excimer Laser

Abstract

To describe the treatment of highly aberrated eyes due to previous excimer laser surgery or trauma. Three eyes (three patients) with reduced visual quality due to previous decentration or corneal laceration (one eye) underwent topography-guided ablation using the CXIII excimer laser (NIDEK Co Ltd) to correct residual refractive error and/or wavefront aberrations. Postoperatively, one patient had a one-line increase in corrected distance visual acuity (CDVA) with a reduction in visual symptoms. At 2 months postoperatively, one patient maintained CDVA, increased uncorrected distance visual acuity from 20/20 to 20/15, and reported resolution of monocular diplopia. In all cases, the functional optical zone increased and wavefront aberrations decreased with selective flattening of the intended corneal region. Topography-guided ablation is an effective treatment of severe corneal aberrations due to surgery or trauma and can be selectively used to treat higher order aberrations with or without refractive error.