Corneal Wavefront-Guided Ablation Showcases Promise in Radial Keratotomy Aftermath

Strategic Insights -

A 68-year-old woman, who underwent radial keratotomy treatment years prior, presented with a significant reduction in visual acuity due to a nuclear cataract in both eyes. The patient's uncorrected distance visual acuity (UDVA) was 20/160 or worse in both eyes, while corrected distance visual acuity (CDVA) improved to 20/40- and 20/50+, respectively, after undergoing corneal wavefront-guided ablation. The study demonstrated that the used protocol improved corneal optics while minimizing tissue removal in refractive surgery, which may provide a new approach for patients who have undergone radial keratotomy and develop cataracts.

Key Takeaways:

  • A 68-year-old woman with radial keratotomy treatment years prior presented with a significant reduction in visual acuity due to a nuclear cataract in both eyes.
  • The patient's UDVA was 20/160 or worse in both eyes before undergoing corneal wavefront-guided ablation.
  • The used protocol improved corneal optics while minimizing tissue removal in refractive surgery.
  • The study demonstrated a significant improvement in the patient's visual acuity after the procedure, with CDVA improving to 20/40- and 20/50+, respectively.
  • The research concluded that eliminating most corneal higher order aberrations may recover visual function in highly aberrated eyes with cataract to an extent that may help some patients to postpone cataract surgery.
  • The study highlights the potential of corneal wavefront-guided ablation as a new approach for patients who have undergone radial keratotomy and develop cataracts.
  • The patient was satisfied with the outcome after ablation and refused/delayed/postponed the cataract surgery.

The study used the SCHWIND AMARIS excimer laser for ablative treatment and analyzed preoperative and postoperative corneal wave aberrations using the MS-39 anterior segment optical coherence tomographer (CSO). The research demonstrated a significant reduction in corneal higher-order aberrations, including coma, spherical aberration, and tetrafoil, in both eyes. The study's findings suggest that further clinical evaluations are needed to confirm the preliminary results.

Statistics:

  • 68-year-old woman's age at the time of the study.
  • 20/160 or worse UDVA in both eyes before corneal wavefront-guided ablation.
  • 20/40- and 20/50+ CDVA improvement in both eyes after the procedure.
  • 60% reduction in corneal aberrations compared to preoperative baseline levels.
  • 38% and 62% reduction in coma and spherical aberration, respectively, in the right eye.
  • 75% and 33% reduction in tetrafoil in the right and left eyes, respectively.

Sources:

  • NewsRx. Findings from Samuel Arba-Mosquera and Co-Authors Provide New Insights into Radial Keratotomy (Total Corneal Wavefront-guided Ablation for Optical Improvement of a Patient After Radial Keratotomy and Before Cataract Surgery). Medical Devices & Surgical Technology Week. October 26, 2025; p 564.
  • Arba-Mosquera, S. et al. Total Corneal Wavefront-guided Ablation for Optical Improvement of a Patient After Radial Keratotomy and Before Cataract Surgery. Journal of Refractive Surgery, 2025;41(10).