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Surface ablation still useful despite rise of LASIK

It is still worth considering surface ablation in thin corneas, irregular corneas, dry eyes, young patients, lower range of refractive errors and Epithelial Basement Membrane Dystrophy.

Priscilla Lynch

Posted: Saturday, February 20, 2021


Jesper Hjortdal MD, PhD

THERE is still room for surface ablation, despite the rise of LASIK in recent decades, Jesper Hjortdal MD, PhD, Denmark, told the 25th ESCRS Winter Meeting Virtual 2021.
Speaking during the Refractive Surgery Course – Corneal session, Prof. Hjortdal outlined the development of surface ablation, which was the first excimer laser-based procedure for changing the refractive power of the cornea.
While PRK was the original technique, it had issues with slow wound healing and visual recovery, pain until the epithelium had healed and haze, he noted.
There was a change towards LASIK in the mid1990s, with its faster healing and visual recovery benefits, but refinements of the original surface ablation technique have improved outcomes as well as pharmacological modification, i.e. the addition of mitomycin C, which reduces haze risk, Prof Hjortdal explained.
The surgical improvements are mainly due to technological perfection of the excimer lasers with respect to optimising the ablation profiles and eye-tracking during treatment.
“There are certain advantages of surface ablation compared to LASIK; there is no flap so that is the main advantage, you don’t have surgical complications – no flap folds, epithelial ingrowth, trauma, late dislocation or ectasia, which can happen after LASIK,” he said.
Concluding, he said it is still worth considering surface ablation in thin corneas, irregular corneas, dry eyes, young patients, lower range of refractive errors and Epithelial Basement Membrane Dystrophy.