Photorefractive keratectomy with customized segmental ablation to correct irregular astigmatism after laser in situ keratomileusis

PURPOSE: To correct irregular astigmatism after laser in situ keratomileusis (LASIK) with customized segmental ablation using the Nidek OPD-Scan (ARK-10000) to guide the Nidek EC-5000 excimer laser with the Final Fit software. METHODS: One eye of a patient that had undergone LASIK and one enhancement was treated using photorefractive keratectomy (PRK) with customized segmental ablation. OPD-Scan maps were analyzed before and after surgery. The Final Fit software was used to link the OPD-Scan to the EC-5000 laser to guide the customized ablation. RESULTS: At 1 month postoperatively, best spectacle-corrected visual acuity had improved from 20/20-2 to 20/15-2, the patient's subjective evaluation of vision was markedly improved, and the postoperative OPD-Scan maps appeared more regular. CONCLUSION: Customized segmental ablation can be performed using the Nidek OPD-Scan and Final Fit software to improve best spectacle-corrected visual acuity and minimize irregular astigmatism, which may result from prior surgical procedures.