ABSTRACT
Laser in situ keratomileusis has become the procedure of choice in the treatment of low and moderate myopia. In the early days, LASIK was also widely used to treat high myopia (1,2). Decentration of the ablation, central islands in broad-beam lasers, and other factors have contributed to induce irregular astigmatism in a certain number of eyes treated. Irregular astigmatism caused by surface asymmetries of the cornea may only be corrected with hard contact lenses. In many cases fitting of these lenses is very difficult, and many are not tolerated by the patients. The use of a customized ablation pattern like in TopoLink LASIK is aimed just in the same direction. Spot-scanning or flying-spot excimer lasers provide the technological platform to perform ablations of any shape (3). Corneal topography enables us to measure the shape of the individual cornea with great precision. Could we combine corneal topography and scanning lasers to create customized ablations? This question posed quite a challenge when we started to treat our first patients with so-called TopoLink LASIK a few years ago (4). Several systems, including the C-Scan (Technomed Co., Baesweiler, Germany) and the Orbscan II corneal tomography system (Bausch & Lomb Surgical, Claremont, CA) were used. We initially treated eyes that had previously undergone refractive surgery (“repair procedures”) (5) and then also included so-called normal eyes, which underwent a routine LASIK procedure. In this chapter, I will describe the technique of TopoLink LASIK based on corneal topography and present some examples as well as the results of the repair procedures and of the normal eyes.
