Topography-guided surface ablation for forme fruste keratoconus.

PURPOSE: To evaluate the efficacy of customized surface ablation in cases of forme fruste keratoconus.

DESIGN

Prospective noncomparative case series.

PARTICIPANTS

Eleven 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.

INTERVENTION: Topography-guided customized surface ablation by means of a scanning spot excimer laser.

MAIN OUTCOME MEASURES: Visual acuity, refraction, quality of vision (ghosting), corneal topography including the Zernike parameter Z3.

RESULTS

Statistically 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 > or =1 lines in best spectacle-corrected visual acuity; however, 7 of 11 eyes gained > or = 1 line.

CONCLUSION

Topography-guided surface ablation is a promising option to rehabilitate vision in contact lens-intolerant patients with forme fruste keratoconus.