| Purpose: A patient with successful treatment of -6 diopters of myopia and postoperative UCDVA of 20/25 to 20/20 complained about poor vision quality.
Methods:
Corneal topography, total and corneal wavefront and refraction data were analysed on several occasions over a period of more than 18 months. Than an enhacement with wavefront optimized ORK-CAM using the Schwind ESIRIS Excimer Laser was performed.
Results:
Postoperative course of the left eye was uneventful after inital laser therapy. An UCDVA of 20/25 was reached after 7 days. After 2 months VA dropped to 20/30 and small wrinkles could be seen in the interface. Under local steroid and artificial tears treatment UCDVA increased to 20/25- to 20/20- , but the patient still complained about poor vision quality, e.g. small halos, slight double vision, photic phenomena. 16 months after the primary treatment a LASEK enhancement based on ORK-CAM data were performed with an ablation of about +0.25/-0.60/0o. After complete re-epithelialisation the patient finally achieved an UCDVA of 20/16- and reported no photic complains anymore.
Discussion:
Even in an unhappy 20/20 patients a thorough evaluation of corneal and total wavefront errors and use of wavefront optimised ORK-CAM makes it possible to solve the problems and complains.
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