Original ArticleTopography-Guided Surface Ablation for Forme Fruste Keratoconus
Review articleOpen access

PurposeTo evaluate the efficacy of customized surface ablation in cases of forme fruste keratoconus.DesignProspective noncomparative case series.ParticipantsEleven eyes of 8 contact lens-intolerant patients with forme fruste keratoconus treated at the Institute of Refractive and Ophthalmic Surgery and the University Eye Clinic Zurich.InterventionTopography-guided customized surface ablation by means of a scanning spot excimer laser.Main Outcome MeasuresVisual acuity, refraction, quality of vision (ghosting), corneal topography including the Zernike parameter Z3.ResultsStatistically significant reduction of manifest refractive error, corneal irregularity, and ghosting. The spherical equivalent was reduced by −2.8±0.62 diopters (D) (P = 0.0007), the cylinder by 1.34 ± 0.18 D (P = 0.015), Z3 was reduced by 41% (P<0.001), and all patients had less ghosting compared to their preoperative status. No eye lost ≥1 lines in best spectacle-corrected visual acuity; however, 7 of 11 eyes gained ≥ 1 line.ConclusionTopography-guided surface ablation is a promising option to rehabilitate vision in contact lens-intolerant patients with forme fruste keratoconus.

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