Topography-guided Custom Ablation for Irregular Corneal Astigmatism Using the NIDEK NAVEX Laser System

PURPOSE: To determine whether topography-guided custom ablation produces acceptable outcomes in the treatment of irregular corneal astigmatism caused by previous corneal surgery or corneal disease. METHODS: Thirteen eyes of nine patients who had irregular corneal astigmatism from previous corneal surgery or corneal disease were treated with customized aspheric treatment zone (CATz) ablations using the NIDEK Advanced Vision Excimer Laser System (NAVEX). Changes in corneal surface regularity index, surface asymmetry index, asymmetry component, corneal and ocular higher order aberrations, uncorrected visual acuity, and best spectacle-corrected visual acuity (BSCVA) were analyzed using Wilcoxon and paired t tests. A P value < .05 was considered statistically significant. RESULTS: After CATz treatment, 62% of eyes (8 of 13) showed an increase in BSCVA. Improvements in both the surface asymmetry index and asymmetry components were statistically significant after CATz treatment (P < .05). CONCLUSIONS: Topography-guided custom ablation can be safe and effective in the management of irregular corneal astigmatism due to previous corneal surgery or corneal disease.