LASIK could now be possible in patients previously excluded

Epithelial thickness profiles may make it possible for LASIK to be performed in eyes that may otherwise have been excluded because of topographic suspect keratoconus, according to Dan Reinstein and colleagues from the London Vision Clinic, London, UK.

In his study, eyes suspected of keratoconus were scanned with Artemis very high-frequency (VHF) digital ultrasound. A diagnosis was confirmed if the epithelial thickness profile demonstrated relative epithelial thinning coincident with the topographically suspected cone.

LASIK was then performed in all eyes where keratoconus was excluded by finding relatively thicker epithelium over the topographically suspected cone. Patients were followed for one year and a matched control group was randomly generated to compare refractive outcomes.

Out of a total of 1,352 consecutive myopic eyes, 104 (7.7%) were classified as keratoconus suspects. After Artemis scanning, 14 eyes (17%) were confirmed as having keratoconus and 90 eyes (40 subjects) were found to be non-keratoconic and underwent LASIK. A control for each study eye was matched within 0.50 D for sphere, cylinder and spherical equivalent (SE). The average change in SE between three months and one-year follow-up was -0.03 D for the keratconus suspect group and -0.09 D for the control group.

The researchers concluded that epithelial thickness profiles may allow LASIK to be performed in eyes that, in the past, would have been excluded because of topographic suspect keratoconus.