Long-term Outcomes of a New Surgical Technique for Corneal Remodeling in Corneal Ectasia.

PURPOSE: To analyze the outcomes of a new technique (corneal remodeling) to treat corneal ectasia. METHODS: Sixty-nine cases that underwent corneal remodeling were analyzed. Anesthetic drops were instilled and a femtosecond laser platform was used to perform an 8-mm diameter keratectomy (180°, 270°, or 360°). Once ablation was completed, the edges of the resection were sutured with 8 to 12 interrupted stitches. RESULTS: Three-year follow-up data are presented. The age of the population was 30.83 ± 12.65 years (range: 16 to 48 years). At 36 months postoperatively, 57.2% presented with uncorrected distance visual acuity (UDVA) of 20/100 or worse and 42.8% achieved between 20/80 and 20/40. After performing photorefractive keratectomy in 3 cases, 14.3% presented with UDVA of 20/100 or worse, 57.2% achieved between 20/80 and 20/40, and 28.5% achieved 20/30 or better in 180° arc length keratectomy. Most parameters compared were moderately to statistically significant (P < .05 to < .0000001). CONCLUSIONS: Corneal remodeling is a safe technique that produces corneal flattening, reduction of anterior chamber depth, and decreased optical aberrations. It also offers a possibility to perform complementary refractive procedures. [J Refract Surg. 2019;35(4):261-267.].

A Novel Corneal Remodeling Technique for the Management of Keratoconus.

PURPOSE: To describe a novel technique to reshape the ectatic cornea by means of crescent keratectomy performed with an excimer laser using a mask. METHODS: A crescent-shaped perforation at the base of the mask allowed the laser ablation to be directed only to the intended region, shielding the remaining cornea. This technique was performed in 3 eyes of 3 patients with keratoconus grade 2 to 3. Arcs of 180° and 360° had been performed depending on the severity of the keratoconus. The edges of the crescent were closed by 10-0 nylon interrupted sutures. RESULTS: At 1 year postoperatively, all cases showed improvement in visual acuity, keratometry, and corneal topography. The treatment also reduced optical aberrations and shortened the anterior chamber depth. CONCLUSIONS: Although the preliminary results are promising, there is a need to standardize a nomogram of this technique for treating keratoconus. [J Refract Surg. 2017;33(12):854-856.].