Treatment of highly aberrated eyes using the NIDEK CXIII excimer laser.

Objective: To describe the treatment of highly aberrated eyes due to previous excimer laser surgery or trauma.

Methods: Three eyes (three patients) with reduced visual quality due to previous decentration or corneal laceration (one eye) underwent topography-guided ablation using the CXIII excimer laser (NIDEK Co Ltd) to correct residual refractive error and/or wavefront aberrations.

Results: Postoperatively, one patient had a one-line increase in corrected distance visual acuity (CDVA) with a reduction in visual symptoms. At 2 months postoperatively, one patient maintained CDVA, increased uncorrected distance visual acuity from 20/20 to 20/15, and reported resolution of monocular diplopia. In all cases, the functional optical zone increased and wavefront aberrations decreased with selective flattening of the intended corneal region.

Conclusions: Topography-guided ablation is an effective treatment of severe corneal aberrations due to surgery or trauma and can be selectively used to treat higher order aberrations with or without refractive error.