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Current trends in advanced surface ablation

Trattler, William Ba; Barnes, Scott Db

Current Opinion in Ophthalmology: July 2008 - Volume 19 - Issue 4 - p 330–334
doi: 10.1097/ICU.0b013e3283034210
Refractive surgery: Edited by Roy Chuck

Purpose of review Since their introduction in the mid-1990s, surface ablation techniques have continued to evolve, enabling surgeons to give patients better quality of vision with less postoperative pain. The purpose of this chapter is to discuss that evolution, the common techniques used today, and how to address potential complications.

Recent findings Advanced surface ablation techniques offer advantages over laser in situ keratomileusis, including expanded potential patient profiles, reduced haze and pain postoperatively, and increased quality of vision. Haze reduction via preserved epithelial flaps, smoother stromal beds, and introduction of mitomycin-C intraoperatively have all improved safety outcomes of advanced surface ablation.

Summary Experience has shown us that virtually all patients who are candidates for laser in situ keratomileusis can be candidates for surface ablation, but patients with specific ocular conditions, such as epithelial basement membrane dystrophy, superficial corneal scars, and previous radial keratotomy will have the best outcomes with surface ablation. Surface ablation and laser in situ keratomileusis are comparable in terms of safety and quality of vision. Wavefront-guided photorefractive keratectomy offers better acuity and less induction of higher order aberrations than wavefront-guided laser in situ keratomileusis.

aCenter for Excellence in Eye Care, Baptist Medical Arts Building, Miami, Florida, USA

bWomack Army Medical Center, Department of Ophthalmology, Fort Bragg, North Carolina, USA

Correspondence to William B. Trattler, MD, Center for Excellence in Eye Care, Baptist Medical Arts Building, 8940 North Kendall Drive, Suite 400-E, Miami, FL 33176, USA Tel: +1 305 598 2020; fax: +1 305 274 0426; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.