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Khanjian AT, Khodzhabekyan NV, Tarutta EP, Harutyunyan SG, Milash SV. [Changes in the wavefront and peripheral defocus profile after excimer laser and orthokeratology corneal reshaping in myopia]. Vestn Oftalmol 2023; 139:87-92. [PMID: 38235634 DOI: 10.17116/oftalma202313906187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE This study compares the trends of changes in corneal asphericity, corneal and total aberrations and peripheral refraction in myopic eyes after excimer laser and orthokeratology correction. MATERIAL AND METHODS Aberrometry (OPD-Scan III; Nidek, Japan) was performed in 63 patients (126 eyes) with moderate and high myopia before and after femtosecond laser-assisted in situ keratomileusis (Femto-LASIK; 88 eyes, group 1) and photorefractive keratectomy (PRK; 38 eyes, group 2). Peripheral refraction (Grand Seiko AutoRef/Keratometer) at 15° and 30° from the center of the fovea was observed in 12 patients of group 1 and in 18 patients with a background of orthokeratology correction (group 3). RESULTS Corneal asphericity factor Q transitioned to positive values after PRK and Femto-LASIK. Corneal aberrations: root mean square higher order aberration (RMS HOA) increased in both groups, Tilt 1 increased in group 1 and became negative in group 2, Tilt 2 increased in group 2 and went negative in group 1. Trefoil 6 did not change in group 1 and decreased in group 2. Coma 7 and 8 increased synchronously in both groups. Spherical aberrations (SA) increased in group 1, and went negative in group 2. Total aberrations changed to a lower degree, and these changes were not synchronous with the corneal ones; RMS HOA decreased in group 1 (while corneal RMS increased significantly), and in the PRK group it increased, but much less than the corneal. Total SA increased in group 1 and did not change in group 2. Peripheral myopic defocus formed in all cases, after Femto-LASIK the maximum was in the zone of 30º, after orthokeratology lenses - in the zone of 15º. CONCLUSION Using excimer laser and orthokeratology to reshape the cornea in full accordance with its different profiles have different effects on the wavefront and peripheral refraction of the eye. The internal optics of the eye partially compensates corneal aberrations induced by the excimer laser.
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Affiliation(s)
- A T Khanjian
- Helmholtz National Medical Research Center of Eye Disease, Moscow, Russia
| | - N V Khodzhabekyan
- Helmholtz National Medical Research Center of Eye Disease, Moscow, Russia
| | - E P Tarutta
- Helmholtz National Medical Research Center of Eye Disease, Moscow, Russia
| | - S G Harutyunyan
- Helmholtz National Medical Research Center of Eye Disease, Moscow, Russia
| | - S V Milash
- Helmholtz National Medical Research Center of Eye Disease, Moscow, Russia
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Kang MJ, Hwang J, Chung SH. Comparison of Corneal Wavefront-optimized and Wavefront-guided Alcohol-assisted Photorefractive Keratectomy Using Schwind Amaris 750S Laser for Myopia. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 34:210-218. [PMID: 32495529 PMCID: PMC7269745 DOI: 10.3341/kjo.2019.0087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/21/2019] [Accepted: 01/18/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the visual outcomes and corneal aberrations between wavefront-optimized (WFO) and corneal wavefront-guided (WFG) photorefractive keratectomy (PRK) in low to moderate myopia. Methods Twenty-seven eyes treated with WFO and 29 eyes treated with WFG PRK using a Schwind Amaris 750S Excimer laser were included after 6 months of postoperative follow-up. Uncorrected distance visual acuity, corrected distance visual acuity, refractive errors, corneal higher-order aberrations (HOA) and corneal thickness obtained using a Scheimpflug system, and central ablation depth and volume were evaluated during the preoperative period and again at the postoperative 6-month visits. Results Postoperatively, uncorrected distance visual acuity, corrected distance visual acuity, manifest spherical equivalent, and refractive astigmatism were improved in both groups, and there was no statistically significant difference between the two groups. There was no significant difference in safety, efficacy, or predictability of the refractive outcome. Postoperative total corneal HOA root mean square (RMS), coma RMS, and spherical aberration were significantly increased in both groups. Among these, only spherical aberration showed a significant difference between the two groups, with greater increase in the WFO group at 6 months postoperatively. The changes in corneal HOA RMS and spherical aberration were smaller in the WFG group, and this benefit was marked in eyes with high HOA RMS (≥0.4 µm) and spherical aberration (≥0.2 µm). Even though ablation volume in the WFG group was much larger than that of the WFO group, there was no significant difference in postoperative central and peripheral corneal thickness between the two groups. Conclusions Both WFO and WFG PRK using a Schwind Amaris 750S laser for low to moderate myopia were safe and effective at improving visual and refractive outcomes. However, WFG PRK induced fewer spherical aberrations than WFO PRK and may be more advantageous for eyes with high HOA root mean square or spherical aberration.
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Affiliation(s)
- Min Ji Kang
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jehyung Hwang
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - So Hyang Chung
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
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Frings A, Hassan H, Allan BD. Pyramidal Aberrometry in Wavefront-Guided Myopic LASIK. J Refract Surg 2020; 36:442-448. [PMID: 32644166 DOI: 10.3928/1081597x-20200519-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/19/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate measurement repeatability and clinical results for pyramidal aberrometry in routine myopic wavefront-guided laser in situ keratomileusis (LASIK). METHODS Results from 265 consecutive eyes treated with myopic wavefront-guided LASIK using the Amaris 1050RS Excimer Laser and Peramis pyramidal aberrometer (SCHWIND eye-tech-solutions GmbH) were reviewed. Limits of repeatability were calculated for the aberrometric refraction spherical equivalent and higher order aberrations for the Peramis aberrometer using results from three consecutive scans acquired preoperatively and postoperatively for the first 100 eyes treated. RESULTS The 95% limits of repeatability for pyramidal aberrometric measurement were: 0.3 diopters (D) for sphere, 0.2 D for cylinder, and 0.1 D (dioptric equivalent) for 3rd and 4th order aberration indices. A total of 95% of eyes were within ±0.50 D of the manifest refraction spherical equivalent target postoperatively. Uncorrected distance visual acuity was 20/20 or better in 96% of 232 eyes with a plano refraction target outcome. A total of 97% of eyes had a refraction cylinder of 0.50 D or less. No eyes lost one or more line of corrected distance visual acuity. CONCLUSIONS These data demonstrate good measurement repeatability, safety, and efficacy for pyramidal aberrometry in routine myopic LASIK. [J Refract Surg. 2020;36(7):442-448.].
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Jun I, Kang DSY, Tan J, Choi JY, Heo W, Kim JY, Lee MG, Kim EK, Seo KY, Kim TI. Comparison of clinical outcomes between wavefront-optimized versus corneal wavefront-guided transepithelial photorefractive keratectomy for myopic astigmatism. J Cataract Refract Surg 2019; 43:174-182. [PMID: 28366363 DOI: 10.1016/j.jcrs.2016.11.045] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 11/21/2016] [Accepted: 11/22/2016] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate and compare the clinical outcomes, including visual acuity, refractive errors, and aberrations, between aberration-free transepithelial photorefractive keratectomy (PRK) and corneal wavefront-guided transepithelial PRK in eyes with myopic astigmatism. SETTING Yonsei University College of Medicine and Eyereum Eye Clinic, Seoul, South Korea. DESIGN Retrospective comparative case series. METHODS Patients with myopic astigmatism were treated with aberration-free transepithelial PRK or corneal wavefront-guided transepithelial PRK using a 1050 Hz high-repetition excimer laser. The safety, efficacy, predictability, and corneal aberrations were compared preoperatively and 1, 2, 3, and 6 months postoperatively. RESULTS The study comprised 188 patients (188 eyes); 91 eyes had aberration-free transepithelial PRK and 97 eyes corneal wavefront-guided transepithelial PRK. Six month after surgery, the mean uncorrected distance visual acuity was comparable (-0.06 logMAR ± 0.07 [SD] aberration-free group; -0.06 ± 0.06 logMAR wavefront-guided group). The safety, efficacy, and predictability of refractive and visual outcomes were also comparable between groups. Corneal total root-mean-square (RMS) higher-order aberrations (HOAs) increased after treatment in both groups, although fewer RMS HOAs were induced in the corneal wavefront-guided group than in the aberration-free group. Spherical aberration increased similarly after treatment in both groups. However, coma and trefoil increased only in the aberration-free group. CONCLUSIONS Aberration-free transepithelial PRK and corneal wavefront-guided transepithelial PRK were safe and effective for correction of myopic astigmatism without difference in visual acuity and refractive outcomes. However, the corneal wavefront-guided profile induced fewer corneal aberrations than the aberration-free profile.
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Affiliation(s)
- Ikhyun Jun
- From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore
| | - David Sung Yong Kang
- From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore
| | - Jerry Tan
- From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore
| | - Jin Young Choi
- From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore
| | - Woon Heo
- From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore
| | - Joo Young Kim
- From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore
| | - Min Goo Lee
- From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore
| | - Eung Kweon Kim
- From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore
| | - Kyoung Yul Seo
- From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore
| | - Tae-Im Kim
- From the Institute of Vision Research (Jun, E.K. Kim, Seo, T-i. Kim), the Corneal Dystrophy Research Institute (Jun, E.K. Kim, T-i. Kim), Department of Ophthalmology, the Department of Pharmacology (Jun, Heo, J.Y. Kim, Lee), Brain Korea 21 PLUS Project for Medical Sciences, Severance Biomedical Science Institute, Yonsei University College of Medicine, and the Eyereum Eye Clinic (Kang, Choi), Seoul, South Korea; the Jerry Tan Eye Surgery (Tan), Singapore.
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Kim TI, Alió Del Barrio JL, Wilkins M, Cochener B, Ang M. Refractive surgery. Lancet 2019; 393:2085-2098. [PMID: 31106754 DOI: 10.1016/s0140-6736(18)33209-4] [Citation(s) in RCA: 171] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/29/2018] [Accepted: 12/11/2018] [Indexed: 01/19/2023]
Abstract
Refractive surgery has evolved beyond laser refractive techniques over the past decade. Laser refractive surgery procedures (such as laser in-situ keratomileusis), surface ablation techniques (such as laser epithelial keratomileusis), and photorefractive keratectomy have now been established as fairly safe procedures that produce excellent visual outcomes for patients with low-to-moderate amounts of ametropia. Additionally, a broader selection of options are now available to treat a wider range of refractive errors. Small incision lenticule extraction uses a femtosecond laser to shape a refractive lenticule, which is removed through a small wound. The potential advantages of this procedure include greater tectonic strength and less dry eye. In the future, intracorneal implants could be used to treat hyperopia or presbyopia. Phakic intraocular implants and refractive lens exchange might be useful options in carefully selected patients for correcting high degrees of ametropia. Thus, physicians are now able to provide patients with the appropriate refractive corrective option based on the individual's risk-benefit profile.
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Affiliation(s)
- Tae-Im Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Jorge L Alió Del Barrio
- Cornea, Cataract and Refractive Surgery Unit, Research & Development Department VISSUM Innovation Alicante, Alicante, Spain; Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain
| | - Mark Wilkins
- Department of Ophthalmology, Moorfields Eye Hospital, London, UK
| | - Beatrice Cochener
- Department of Ophthalmology, University Hospital Morvan, Brest, France
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore.
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Kobashi H, Kamiya K, Igarashi A, Takahashi M, Shimizu K. Two-years results of small-incision lenticule extraction and wavefront-guided laser in situ keratomileusis for Myopia. Acta Ophthalmol 2018. [PMID: 28631305 DOI: 10.1111/aos.13470] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare the 2-years visual and refractive outcomes between small-incision lenticule extraction (SMILE) and wavefront-guided laser in situ keratomileusis (LASIK) in eyes with myopia and myopic astigmatism. METHODS Our retrospective case-control study examined 30 eyes of 30 patients with the manifest refraction spherical equivalent (MRSE) of -3.71 ± 1.83 dioptres (D) who underwent SMILE and 30 eyes of 30 patients with MRSE of -3.81 ± 1.40 D who underwent wavefront-guided LASIK. We assessed the 2-years clinical outcomes. RESULTS Logarithm of the minimal angle of resolution (LogMAR)-corrected distance visual acuity (CDVA) was -0.23 ± 0.07 in the SMILE group and -0.24 ± 0.07 in the wavefront-guided LASIK group 2 years postoperatively (p = 0.82). Logarithm of the minimal angle of resolution-uncorrected distance visual acuity (UDVA) was -0.18 ± 0.09 and -0.15 ± 0.11 (p = 0.30, respectively). In the SMILE and wavefront-guided LASIK groups 2 years postoperatively, 100% and 73% of eyes, respectively, were within 0.5 D of the prompted MRSE correction (p = 0.005). Changes in the MRSE of -0.10 ± 0.30 D and -0.23 ± 0.51 D occurred from 3 months to 2 years (p = 0.40, respectively). We found a significant correlation between myopic regression and the changes in the keratometric readings from 3 months to 2 years after wavefront-guided LASIK (r = -0.48, p = 0.002), but not after SMILE (r = -0.004, p = 0.90). CONCLUSION Small-incision lenticule extraction offers better refractive outcomes than wavefront-guided LASIK during a 2-years follow-up for the correction of myopia and myopic astigmatism.
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Affiliation(s)
- Hidenaga Kobashi
- Department of Ophthalmology; University of Kitasato School of Medicine; Kanagawa Japan
| | - Kazutaka Kamiya
- Department of Ophthalmology; University of Kitasato School of Medicine; Kanagawa Japan
| | - Akihito Igarashi
- Department of Ophthalmology; University of Kitasato School of Medicine; Kanagawa Japan
| | - Masahide Takahashi
- Department of Ophthalmology; University of Kitasato School of Medicine; Kanagawa Japan
| | - Kimiya Shimizu
- Department of Ophthalmology; University of Kitasato School of Medicine; Kanagawa Japan
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Ali MA, Kobashi H, Kamiya K, Igarashi A, Miyake T, Elewa MEM, Komatsu M, Shimizu K. Comparison of astigmatic correction after femtosecond lenticule extraction and wavefront-guided LASIK for myopic astigmatism. J Refract Surg 2014; 30:806-11. [PMID: 25437478 DOI: 10.3928/1081597x-20141113-03] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/15/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare postoperative astigmatic correction between femtosecond lenticule extraction (FLEx) and wavefront-guided LASIK in eyes with myopic astigmatism. METHODS Fifty-eight eyes of 41 patients undergoing FLEx and 49 eyes of 29 patients undergoing wavefront-guided LASIK to correct myopic astigmatism were examined. Visual acuity, cylindrical refraction, predictability of the astigmatic correction, and astigmatic vector components were compared between groups 6 months after surgery. RESULTS There was no statistically significant difference in manifest cylindrical refraction (P = .08) or percentage of eyes within ± 0.50 diopter (D) of its refraction (P = .11) between the surgical procedures. The index of success in FLEx was statistically significantly better than that of wavefront-guided LASIK (P = .02), although there was no significant difference between the groups in other indices (eg, surgically induced astigmatism, target-induced astigmatism, astigmatic correction index, angle of error, difference vector, and flattening index). Subgroup analysis showed that FLEx had a better index of success (P = .02) and difference vector (P = .04) than wavefront-guided LASIK in the low cylinder subgroup; the angle of error in FLEx was significantly smaller than that of wavefront-guided LASIK in the moderate cylinder subgroup (P = .03). CONCLUSIONS Both FLEx and wavefront-guided LASIK worked well for the correction of myopic astigmatism by the 6-month follow-up visit. Although FLEx had a better index of success than wavefront-guided LASIK when using vector analysis, it appears equivalent to wavefront-guided LASIK in terms of visual acuity and the correction of astigmatism.
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Kobashi H, Kamiya K, Hoshi K, Igarashi A, Shimizu K. Wavefront-guided versus non-wavefront-guided photorefractive keratectomy for myopia: meta-analysis of randomized controlled trials. PLoS One 2014; 9:e103605. [PMID: 25072409 PMCID: PMC4114780 DOI: 10.1371/journal.pone.0103605] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 07/01/2014] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the efficacy, predictability, safety, and induced higher-order aberrations (HOAs) between wavefront-guided and non-wavefront-guided photorefractive keratectomy (PRK). Methods The Cochrane Central Register of Controlled Trials, PubMED, and EMBASE were searched for randomized controlled trials. Trials meeting the selection criteria were quality appraised, and data was extracted by 2 independent authors. Measures of association were pooled quantitatively using meta-analytical methods. Comparisons between wavefront-guided and non-wavefront-guided ablations were made as pooled odds ratios (ORs) or weighted mean differences. The pooled ORs and 95% confidence intervals (CIs) were computed for efficacy, safety, and predictability. The weighted mean differences and 95% CIs were used to compare induced HOAs. Results The study covered five trials involving 298 eyes. After wavefront-guided PRK, the pooled OR of achieving an uncorrected distance visual acuity of 20/20 (efficacy) was 1.18 (95% CI, 0.53–2.60; p = 0.69), the pooled OR of achieving a result within ±0.50 diopter of the intended target (predictability) was 0.86 (95% CI, 0.40–1.84; p = 0.70). No study reported a loss of 2 or more lines of Snellen acuity (safety) with either modality. In eyes with wavefront-guided PRK, the postoperative trefoil aberrations (mean difference −0.02; 95% CI, −0.03 to −0.00; p = 0.03) were significantly lower. There were no significant differences between the two groups in the postoperative total HOAs (mean difference −0.04; 95% CI, −0.23 to 0.14; p = 0.63), spherical (mean difference 0.00; 95% CI, −0.08 to 0.09; p = 0.93), and coma (mean difference −0.06; 95% CI, −0.14 to 0.03; p = 0.20) aberrations. Conclusions According to the meta-analysis, wavefront-guided PRK offered no advantage in efficacy, predictability, or safety measures over non-wavefront-guided PRK, although it may have induced fewer trefoil aberrations.
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Affiliation(s)
- Hidenaga Kobashi
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
- * E-mail:
| | - Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Keika Hoshi
- Department of Preventive Medicine, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Akihito Igarashi
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Kimiya Shimizu
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
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Kamiya K, Shimizu K, Igarashi A, Kobashi H, Komatsu M. Comparison of visual acuity, higher-order aberrations and corneal asphericity after refractive lenticule extraction and wavefront-guided laser-assisted in situ keratomileusis for myopia. Br J Ophthalmol 2012; 97:968-75. [DOI: 10.1136/bjophthalmol-2012-302047] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mello GR, Rocha KM, Santhiago MR, Smadja D, Krueger RR. Applications of wavefront technology. J Cataract Refract Surg 2012; 38:1671-83. [DOI: 10.1016/j.jcrs.2012.07.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 01/27/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
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Visual performance after posterior chamber phakic intraocular lens implantation and wavefront-guided laser in situ keratomileusis for low to moderate myopia. Am J Ophthalmol 2012; 153:1178-86.e1. [PMID: 22365084 DOI: 10.1016/j.ajo.2011.12.005] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 12/09/2011] [Accepted: 12/09/2011] [Indexed: 11/22/2022]
Abstract
PURPOSE To compare postoperative visual function after implantable collamer lens (ICL) implantation and after wavefront-guided laser in situ keratomileusis (LASIK) in eyes with low to moderate myopia. DESIGN Retrospective observational case study. PATIENTS AND METHODS We investigated 30 eyes of 20 patients undergoing ICL implantation and 64 eyes of 38 patients undergoing wavefront-guided LASIK for the correction of low to moderate myopia (manifest spherical equivalent: -3.00 to -5.88 diopters [D]). Ocular higher-order aberrations (HOAs) and contrast sensitivity (CS) function were measured by Hartmann-Shack aberrometry and a contrast sensitivity unit before and 3 months after surgery, respectively. From the contrast sensitivity, the area under the log contrast sensitivity function was calculated. RESULTS For 4-mm and 6-mm pupils, the changes in ocular third-order aberrations, fourth-order aberrations, and total HOAs after ICL implantation were significantly less than those after wavefront-guided LASIK (P < .05, Mann-Whitney U test). The postoperative area under the log contrast sensitivity function was significantly increased after ICL implantation (P < .001), whereas, after wavefront-guided LASIK, it was not significantly changed (P = .11). CONCLUSIONS ICL implantation induces significantly fewer ocular HOAs than wavefront-guided LASIK. Moreover, CS was significantly improved after ICL implantation but unchanged after wavefront-guided LASIK in eyes with low to moderate myopia. Thus, even in the correction of low to moderate myopia, ICL implantation appears to be superior in visual performance to wavefront-guided LASIK, suggesting that it may be a viable surgical option for the treatment of such eyes.
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Smadja D, Reggiani-Mello G, Santhiago MR, Krueger RR. Wavefront ablation profiles in refractive surgery: description, results, and limitations. J Refract Surg 2012; 28:224-32. [PMID: 22373035 DOI: 10.3928/1081597x-20120217-01] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Accepted: 12/06/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE To provide an overview of the clinical results of different ablation profiles based on wavefront technology and discuss their characteristics and limitations. METHODS Literature review of studies reporting results of ablation profiles based on wavefront technology in virgin healthy eyes. RESULTS Over the past 10 years, a large number of studies comparing different treatment algorithms and newer excimer laser platforms have been published. Thirty-six clinical studies including 3637 eyes analyzing the clinical results obtained after wavefront-guided, wavefront-optimized, and Q-factor profiles have been reviewed. Although wavefront-driven profiles allowed reduction of the amount of induced optical aberrations with conventional ablations, thereby improving the quality of vision, it appears that no algorithm of treatment or excimer laser platform has demonstrated a clear superiority over another. Wound healing and unexpected biomechanical response to surgery affect the accuracy of customized treatments and produce variable results. In addition, it is difficult to rigorously analyze and compare findings among different studies because of the diverse variety in which the data are reported. CONCLUSIONS Despite several technological improvements over the years, wavefront ablation profiles have not consistently demonstrated superiority in terms of visual acuity and lower order aberrations compared to the standard procedure, although the induction of higher order aberrations has been reduced. The concept of an individualized eye model has emerged recently, based on the optical ray tracing algorithm, and could theoretically provide a higher level of customization, thus fulfilling the promise of "super vision."
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Affiliation(s)
- David Smadja
- Refractive Surgery Department, Cole Eye Institute, Cleveland Clinic Foundation, Ohio, USA.
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Smadja D, Reggiani-Mello G, Touboul D, Colin J. Les profils de photoablation cornéenne en chirurgie réfractive. Partie 1 : la quête de l’excellence. J Fr Ophtalmol 2012; 35:126-35. [DOI: 10.1016/j.jfo.2011.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 08/30/2011] [Accepted: 09/02/2011] [Indexed: 10/14/2022]
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Mifflin MD, Hatch BB, Sikder S, Bell J, Kurz CJ, Moshirfar M. Custom vs conventional PRK: a prospective, randomized, contralateral eye comparison of postoperative visual function. J Refract Surg 2012; 28:127-32. [PMID: 22230057 DOI: 10.3928/1081597x-20120103-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 11/28/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine whether VISX S4 (VISX Inc) custom photorefractive keratectomy (PRK) results in better visual outcomes than VISX S4 conventional PRK. METHODS Photorefractive keratectomy was performed on 80 eyes from 40 patients in this randomized, prospective, contralateral eye study. Dominant eyes were randomized to one group with the fellow eye receiving the alternate treatment. Primary outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, and root-mean-square (RMS) higher order aberrations. RESULTS Mean UDVA was -0.023±0.099 (20/19) in the custom group and -0.044±0.080 (20/18) in the conventional group 6 months after surgery (P=.293). Mean CDVA was -0.073±0.067 (20/17) in the custom group and -0.079±0.071 (20/17) in the conventional group 6 months after surgery (P=.659). Total higher order aberration RMS and spherical aberration increased in both groups compared to preoperative values (P<.05). Coma increased in the conventional group (P<.05) whereas it was similar to preoperative values in the custom group. No significant differences were noted in induction of trefoil. CONCLUSIONS Custom and conventional PRK were shown to be safe and effective with excellent visual acuity and contrast sensitivity performance at 6 and 12 months. Conventional PRK induced more coma than custom PRK; however, this did not seem to correlate with clinical outcomes.
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Affiliation(s)
- Mark D Mifflin
- University of Utah, Department of Ophthalmology and Visual Sciences, Salt Lake City, Utah, USA.
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Fares U, Suleman H, Al-Aqaba MA, Otri AM, Said DG, Dua HS. Efficacy, predictability, and safety of wavefront-guided refractive laser treatment: metaanalysis. J Cataract Refract Surg 2011; 37:1465-75. [PMID: 21782089 DOI: 10.1016/j.jcrs.2011.02.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 02/23/2011] [Accepted: 02/26/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare the efficacy, predictability, safety, and induced higher-order aberrations (HOAs) between wavefront-guided and non-wavefront-guided ablations. SETTING Division of Ophthalmology and Visual Sciences, University of Nottingham, Nottingham, United Kingdom. DESIGN Metaanalysis. METHODS The Cochrane Central Register of Controlled Trials, PubMED, and EMBASE were searched for randomized controlled trails. Trials meeting the selection criteria were quality appraised and data extracted by 2 independent authors. Measures of association were pooled quantitatively using metaanalytical methods. Comparison between wavefront-guided and non-wavefront-guided ablations was measured as pooled odds ratios (ORs) or weighted mean differences. The pooled ORs and 95% confidence intervals (CIs) were computed for efficacy, safety, and predictability. The weighted mean difference and 95% CIs were used to compare induced HOAs. RESULTS Eight trials involving 955 eyes were included. After wavefront-guided LASIK, the pooled OR of achieving uncorrected distance visual acuity (UDVA) of 20/20 (efficacy) was 1.10 (95% CI, 0.66-1.83; P=.72), the pooled OR of achieving a result within ± 0.50 diopter of intended target (predictability) was 1.03 (95% CI, 0.60-1.75; P=.92), and the weighted mean difference in induced HOAs was -0.09 (95% CI, -0.17 to -0.01; P=.04). No study reported loss of 2 or more lines of Snellen acuity (safety) with either modality. CONCLUSIONS Metaanalysis showed no clear evidence of a benefit of wavefront-guided over non-wavefront-guided ablations. However, there was a lack of standardized reporting of UDVA better than 20/20, which might mask an advantage in wavefront-guided treatment. With high preexisting HOAs, wavefront-guided has advantages over non-wavefront-guided treatment.
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Affiliation(s)
- Usama Fares
- Division of Ophthalmology and Visual Sciences, University of Nottingham, Nottingham, United Kingdom
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Kamiya K, Umeda K, Igarashi A, Ando W, Shimizu K. Factors influencing the changes in coma-like aberrations after myopic laser in situ keratomileusis. Curr Eye Res 2011; 36:905-9. [PMID: 21950695 DOI: 10.3109/02713683.2011.593729] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess factors affecting changes in coma-like aberrations after myopic laser in situ keratomileusis (LASIK). METHODS We retrospectively examined 91 eyes of 48 patients undergoing LASIK (mean patient age ± standard deviation, 29.6 ± 8.1 years; gender, 29 male and 19 female; manifest refraction, -4.76 ± 1.42 diopters). We quantitatively assessed the values of coma-like aberrations for 4-mm and 6-mm pupils using a Hartmann-Shack aberrometer before and 3 months after surgery. Multiple regression analysis was used to assess the relevant factors of the changes in coma-like aberrations. RESULTS The mean changes in coma-like aberrations for 4-mm and 6-mm pupils were 0.08 ± 0.09 μm and 0.31 ± 0.30 μm, respectively. Explanatory variables relevant to the changes in coma-like aberrations were, in order of influence, amount of spherical equivalent correction (partial regression coefficient B = 0.022, p <0.001 for a 4-mm pupil, B = 0.090, p <0.001 for a 6-mm pupil), and surgical technique (B = -0.062, p = 0.01 for a 4-mm pupil, B = -0.169, p = 0.03 for a 6-mm pupil). No significant correlation was seen with other clinical factors such as age, gender, astigmatism correction, mean keratometric readings, central corneal thickness, or eye tracking (with or without). CONCLUSIONS High myopic eyes requiring larger amounts of laser correction and eyes undergoing conventional LASIK tend to induce more coma-like aberration after surgery. Wavefront-guided LASIK may be a better surgical approach for preventing the induction of coma-like aberrations, especially in eyes with high myopia.
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Affiliation(s)
- Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Sagamihara, Kanagawa, Japan.
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El Awady HE, Ghanem AA, Saleh SM. Wavefront-optimized ablation versus topography-guided customized ablation in myopic LASIK: comparative study of higher order aberrations. Ophthalmic Surg Lasers Imaging Retina 2011; 42:314-20. [PMID: 21534496 DOI: 10.3928/15428877-20110421-01] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Accepted: 03/24/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To compare the outcomes of wavefront-optimized ablation and topography-guided ablation in fellow eyes of patients undergoing laser in situ keratomileusis (LASIK) for myopia. PATIENTS AND METHODS This prospective study included 84 patients who underwent LASIK in both eyes: wavefront-optimized ablation in one eye (group I) and topography-guided ablation in the fellow eye (group II). The Moria2 microkeratome with a 110 single-use head (Moria, Antony, France) was used to create a superior hinged flap and the Allegretto Wave Excimer Laser (Alcon/Wavelight Light Laser Technologie GmbH, Erlangen, Germany) for photoablation. The Allegretto wave analyzer was used to measure the ocular aberrations before and 6 months after LASIK. Refractive visual outcomes and ocular aberration changes were compared between the two treatment modalities. RESULTS Six months postoperatively, the mean uncorrected visual acuity of group II was statistically better than that of group I (P = .02). Seventy percent of group I and 83% of group II achieved a postoperative spherical equivalent refraction of ±0.5 diopters. The postoperative total root-mean-square of higher order aberrations (HOAs) of group II was smaller than that of group I, but the difference was not statistically significant (P = .51). There was a decrease in most of the individual terms of HOAs in group II, but it was only statistically significant in Z(3) (-1) (P = .04). The reverse occurred in group I, where most of the individual terms of HOAs increased, but it was not statistically significant. Significant improvement was only noted in Z(5) (3) (P = .05) and Z(5) (5) (P = .04). CONCLUSION Both wavefront-optimized ablation and topography-guided ablation provided good refractive results, but the latter induced fewer HOAs.
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Affiliation(s)
- Hatem E El Awady
- Ophthalmology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Miraftab M, Seyedian MA, Hashemi H. Wavefront-Guided vs Wavefront-Optimized LASIK: A Randomized Clinical Trial Comparing Contralateral Eyes. J Refract Surg 2011; 27:245-50. [DOI: 10.3928/1081597x-20100812-02] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2009] [Accepted: 07/06/2010] [Indexed: 11/20/2022]
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Einighammer J, Oltrup T, Bende T, Jean B. Real Ray Tracing Simulation Versus Clinical Outcomes of Corneal Excimer Laser Surface Ablations. J Refract Surg 2010; 26:625-37. [DOI: 10.3928/1081597x-20100319-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Accepted: 02/09/2010] [Indexed: 11/20/2022]
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Karimian F, Feizi S, Jafarinasab MR. Conventional versus custom ablation in photorefractive keratectomy: randomized clinical trial. J Cataract Refract Surg 2010; 36:637-43. [PMID: 20362857 DOI: 10.1016/j.jcrs.2009.10.050] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Revised: 10/09/2009] [Accepted: 10/22/2009] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare visual outcomes and changes in total higher-order aberrations (HOAs) between conventional photorefractive keratectomy (PRK) and custom PRK SETTING: Department of Ophthalmology, Labbafinejad Medical Center, Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences and Negah Eye Center, Tehran, Iran. METHODS This clinical trial comprised eyes having bilateral myopic PRK with the Technolas 217z excimer machine. One eye had conventional ablation (conventional group) and the other eye, wavefront-guided custom treatment (custom group). Changes in postoperative visual acuity, cycloplegic refraction, contrast sensitivity function, and root mean square higher-order aberrations (RMS HOAs) were compared between the 2 groups. RESULTS The mean age of the 28 patients (56 eyes) was 26.7 years. The mean preoperative cycloplegic spherical equivalent refractive error was -4.92 diopters (D) +/- 1.6 (SD) and the mean refractive astigmatism, 0.91 +/- 1.0 D. There was no statistically significant difference between the 2 groups in preoperative cycloplegic refractive error, HOAs, or contrast sensitivity function. The mean follow-up was 8.1 +/- 3.3 months. The increase in RMS HOAs from preoperatively to postoperatively was statistically significantly higher in the custom group in the 6.0 mm zone (P = .03) but not in the 4.0 mm zone (P = .26). The decrease in low mesopic contrast sensitivity function was statistically significant in both groups. CONCLUSIONS The RMS HOAs significantly increased after PRK with both methods. The results suggest that custom ablation is more sensitive to optical zone (OZ) size and may yield more aberrations with an OZ smaller than 6.0 mm.
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Affiliation(s)
- Farid Karimian
- Ophthalmic Research Center, Labbafinejad Medical Center, Tehran, Iran.
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Visual performance after implantable collamer lens implantation and wavefront-guided laser in situ keratomileusis for high myopia. Am J Ophthalmol 2009; 148:164-70.e1. [PMID: 19375059 DOI: 10.1016/j.ajo.2009.02.001] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 01/27/2009] [Accepted: 02/03/2009] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare postoperative visual function after implantable collamer lens (ICL; STAAR Surgical, Nidau, Switzerland) implantation and after wavefront-guided laser in situ keratomileusis (WFG-LASIK) in eyes with high myopia. DESIGN Retrospective, observational case study. METHODS We investigated 46 eyes of 33 patients undergoing ICL implantation and 47 eyes of 29 patients undergoing WFG-LASIK (Technolas217z; Bausch & Lomb, Rochester, New York, USA) for the correction of high myopia (manifest spherical equivalent < or = -6 diopters). Ocular higher-order aberrations (HOA) and contrast sensitivity (CS) function were measured by Hartmann-Shack aberrometry (KR-9000; Topcon, Tokyo, Japan) and a CS unit (VCTS-6500; Vistech Consultants Inc, Dayton, Ohio, USA) before and 3 months after surgery, respectively. From the CS, the area under the log CS function (AULCSF) was calculated. RESULTS For a 4-mm pupil, the changes in ocular coma-like aberrations, spherical-like aberrations, and total HOAs after ICL implantation were significantly less than those after WFG-LASIK (P < .001, Mann-Whitney U test). The postoperative AULCSF was significantly increased after ICL implantation (P < .001), whereas after WFG-LASIK, it was significantly decreased (P < .001). CONCLUSIONS ICL implantation induces significantly fewer ocular HOAs than WFG-LASIK. Moreover, CS was improved significantly after ICL implantation, but deteriorated after WFG-LASIK in eyes with high myopia. Thus, in the correction of high myopia, ICL implantation seems to be superior in visual performance to WFG-LASIK, suggesting that it may be a better surgical option for the treatment of such eyes.
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Padmanabhan P, Mrochen M, Basuthkar S, Viswanathan D, Joseph R. Wavefront-guided versus wavefront-optimized laser in situ keratomileusis: contralateral comparative study. J Cataract Refract Surg 2008; 34:389-97. [PMID: 18299062 DOI: 10.1016/j.jcrs.2007.10.028] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2007] [Accepted: 10/22/2007] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare the outcomes of wavefront-guided and wavefront-optimized treatment in fellow eyes of patients having laser in situ keratomileusis (LASIK) for myopia. SETTING Medical and Vision Research Foundation, Tamil Nadu, India. METHODS This prospective comparative study comprised 27 patients who had wavefront-guided LASIK in 1 eye and wavefront-optimized LASIK in the fellow eye. The Hansatome (Bausch & Lomb) was used to create a superior-hinged flap and the Allegretto laser (WaveLight Laser Technologie AG), for photoablation. The Allegretto wave analyzer was used to measure ocular wavefront aberrations and the Functional Acuity Contrast Test chart, to measure contrast sensitivity before and 1 month after LASIK. The refractive and visual outcomes and the changes in aberrations and contrast sensitivity were compared between the 2 treatment modalities. RESULTS One month postoperatively, 92% of eyes in the wavefront-guided group and 85% in the wavefront-optimized group had uncorrected visual acuity of 20/20 or better; 93% and 89%, respectively, had a postoperative spherical equivalent refraction of +/-0.50 diopter. The differences between groups were not statistically significant. Wavefront-guided LASIK induced less change in 18 of 22 higher-order Zernike terms than wavefront-optimized LASIK, with the change in positive spherical aberration the only statistically significant one (P= .01). Contrast sensitivity improved at the low and middle spatial frequencies (not statistically significant) and worsened significantly at high spatial frequencies after wavefront-guided LASIK; there was a statistically significant worsening at all spatial frequencies after wavefront-optimized LASIK. CONCLUSION Although both wavefront-guided and wavefront-optimized LASIK gave excellent refractive correction results, the former induced less higher-order aberrations and was associated with better contrast sensitivity.
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Bababeygy SR, Zoumalan CI, Manche EE. Visual outcomes of wavefront-guided laser in situ keratomileusis in eyes with moderate or high myopia and compound myopic astigmatism. J Cataract Refract Surg 2008; 34:21-7. [PMID: 18165076 DOI: 10.1016/j.jcrs.2007.08.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2007] [Accepted: 08/13/2007] [Indexed: 10/22/2022]
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Kohnen T, Kühne C, Bühren J. The future role of wavefront-guided excimer ablation. Graefes Arch Clin Exp Ophthalmol 2007; 245:189-94. [PMID: 16957938 DOI: 10.1007/s00417-006-0422-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Accepted: 07/13/2006] [Indexed: 01/09/2023] Open
Affiliation(s)
- Thomas Kohnen
- Department of Ophthalmology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
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Moshirfar M, Espandar L, Meyer JJ, Tanner JR, Holz HA. Prospective randomized trial of wavefront-guided laser in situ keratomileusis with the CustomCornea and CustomVue laser systems. J Cataract Refract Surg 2007; 33:1727-33. [PMID: 17889767 DOI: 10.1016/j.jcrs.2007.06.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Accepted: 06/08/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE To compare visual function, safety, and higher-order aberrations (HOAs) after wavefront-guided laser in situ keratomileusis (LASIK) with the LadarVision CustomCornea (Alcon Laboratories, Inc.) and Star S4 CustomVue (Visx) laser systems. SETTING John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. METHODS Seventy-eight eyes of 39 patients with myopia with or without astigmatism were randomized for LASIK treatment in 1 eye with the CustomCornea laser; the other eye was treated with the CustomVue laser. Patients were followed for 6 months after surgery. The primary outcome measures were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and changes in HOAs. RESULTS At 6 months, the mean logarithm of the minimum angle of resolution (logMAR) UCVA was -0.0135 +/- 0.07 (SD) in the CustomVue group and 0.0417 +/- 0.12 in the CustomCornea group (P = .023). Eighty-eight percent of eyes in the CustomVue group had 20/20 or better UCVA compared with 67% in the CustomCornea group (P<.02). At 6 months, 91% of eyes in the CustomVue group and 79% in the CustomCornea group were within +/-0.50 diopter (D) of emmetropia (P<.1); 88% and 50%, respectively, were within +/-0.25 D (P<.001). Both platforms led to a small increase in total HOAs. The CustomVue system reduced trefoil and induced less of an increase in total HOAs, whereas the CustomCornea platform increased trefoil but induced less of an increase in spherical aberrations and coma. CONCLUSIONS Both laser systems were effective, safe, and predictable. Wavefront-guided LASIK with the CustomVue system resulted in better visual acuity, with more eyes having 20/20 acuity than in the CustomCornea group.
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Affiliation(s)
- Majid Moshirfar
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah 84121, USA.
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Binder PS, Rosenshein J. Retrospective comparison of 3 laser platforms to correct myopic spheres and spherocylinders using conventional and wavefront-guided treatments. J Cataract Refract Surg 2007; 33:1158-76. [PMID: 17586371 DOI: 10.1016/j.jcrs.2007.03.040] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2006] [Accepted: 03/26/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare 3 excimer laser platforms for the correction of myopic spheres and myopic spherocylinders using conventional algorithms or wavefront-guided treatments. SETTING Private practice, in-office laser facility. METHODS This retrospective comparative interventional case series comprised 458 patients (721 eyes). Sequentially selected patient eyes had laser in situ keratomileusis surgery by the same surgeon using 1 of 3 lasers (Visx Star S4, LADARVision 4000, WaveLight Allegretto) with a conventional algorithm or with wavefront-guided software. The same aberrometer was used before and after surgery in a given eye. A femtosecond laser (IntraLase Corp.) was used for flap creation. Parametric and nonparametric 1-way analysis of variance and regression analysis were performed. Outcomes were analyzed for change in visual, refractive, and wavefront categories. RESULTS On average, all lasers improved uncorrected visual acuity and best spectacle-corrected visual acuity, produced predictable refractive change, and induced higher-order aberrations (HOAs). Overall, the Star S4 wavefront treatment improved results compared with Star S4 conventional treatment; however, LADARVision wavefront treatment did not improve the conventional results. The Allegretto produced the best results in the category of visual acuity in spherocylinder eyes only. The Star S4 wavefront treatment produced the best HOA results for sphere and spherocylinder. In the spherocylinder group, the LADARVision reduced astigmatism and defocus the most. CONCLUSION These results document that different laser platforms achieve statistically significantly different outcomes depending on refractive, patient, and surgical variables.
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Affiliation(s)
- Perry S Binder
- Department of Medical Physics, Oakland University, Rochester, USA.
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Zhou C, Jin M, Wang X, Ren Q. Corneal Wavefront-guided Ablation With the Schwind ESIRIS Laser for Myopia. J Refract Surg 2007; 23:573-80. [PMID: 17598576 DOI: 10.3928/1081-597x-20070601-07] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the outcome of corneal wavefront-guided LASIK for the treatment of myopia and myopic astigmatism. METHODS This study included 56 myopic virgin eyes of 28 patients with a mean spherical equivalent refraction of -4.40 +/- 1.83 diopters (D) (range: -1.25 to -9.75 D) and astigmatism < 2.50 D. The corneal wavefront aberrations were analyzed using a corneal topography system. The preoperative corneal wavefront aberration data obtained from the above analyses combined with manifest refraction were used to generate a customized ablation profile. The safety, efficacy, and predictability of the correction, contrast sensitivity, and corneal higher order wavefront aberrations were evaluated. RESULTS At 1-year follow-up, the mean residual spherical equivalent refractive error was -0.15 +/- 0.3 D (range: 0 to -1.25 D) and mean cylinder was -0.54 +/- 0.34 D (range: 0 to -1.50 D). Ninety-five percent of eyes were in the residual refractive error range of +/- 0.50 D and uncorrected visual acuity improved by 1.00 D or better in 94% of eyes. The safety index and efficacy index were 1.13 and 0.92, respectively. After treatment, corneal higher order wavefront aberrations with a 6-mm pupil diameter increased significantly (paired sample t test, P < .01), and contrast sensitivity with glare had small reductions at high spatial frequencies. Changes in spherical-like aberration (R = 0.708, P < .001) and higher order wavefront aberration (R = 0.449, P = .001), except for coma-like aberration (P = .238), were positively correlated with the amount of achieved correction. CONCLUSIONS Evaluation of clinical results showed that corneal wavefront-guided LASIK for the correction of myopia and myopic astigmatism was safe and effective. There was an increase in all higher order aberrations postoperatively.
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Affiliation(s)
- Chuanqing Zhou
- Laboratory of Ophthalmology & Visual Optics, Institute for Laser Medicine and Bio-Photonics, Department of Biomedical Engineering, College of Life Science and Technology, Shanghai Jiaotong University, Shanghai, China
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Lee HW, Park SC, Park DW, Chung TY, Chung ES. Comparative Analysis of Postoperative Changes in Higher Order Aberrations Following LASIK and Laser Thermal Keratoplasty. J Refract Surg 2007; 23:224-5. [PMID: 17385286 DOI: 10.3928/1081-597x-20070301-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Awwad ST, Bowman RW, Cavanagh HD, McCulley JP. Wavefront-guided LASIK for Myopia Using the LADAR CustomCornea and the VISX CustomVue. J Refract Surg 2007; 23:26-38. [PMID: 17269241 DOI: 10.3928/1081-597x-20070101-06] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the objective and subjective visual outcomes and refractive results of wavefront-guided LASIK with LADAR CustomCornea and VISX CustomVue. METHODS This prospective randomized single-institution multisurgeon study comprised 100 eyes of 58 patients (50 eyes on each laser platform). Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and manifest refraction were measured postoperatively at 1 day, 1 week, 1 month, and 3 months. Contrast sensitivity, higher order aberrations measurement, and a subjective vision questionnaire were performed preoperatively and at 3 months. RESULTS Preoperatively, the CustomCornea group had a mean manifest sphere of -3.58 +/- 1.61 diopters (D) (range: -0.50 to -7.25 D), cylinder of +0.64 +/- 0.45 D (range: 0 to +1.75 D), and manifest refractive spherical equivalent (MRSE) of -3.26 +/- 1.56 D. The CustomVue group had a manifest sphere of -4.00 +/- 1.69 D (range: -1.50 to -7.50 D), cylinder of +0.60 +/- 0.52 D (range: 0 to +2.00 D), and MRSE of -3.70 +/- 1.64 D. At 3 months, 94% of CustomCornea eyes and 84% of CustomVue eyes had UCVA > or = 20/20 (P = .20). Twenty-four percent of CustomVue eyes and 22% of CustomCornea eyes gained 1 line of BSCVA. In both groups, 96% of eyes were within 0.50 D of emmetropia. Mean CustomCornea glare contrast sensitivity improved (P = .04) whereas more eyes improved than worsened in both groups. Spherical aberration and total higher order aberrations increased, and trefoil decreased in both groups. A decrease in coma was noted in 70% of CustomCornea eyes. CONCLUSIONS Wavefront-guided LASIK with both platforms is safe, effective, and delivers excellent visual results. CustomCornea improves contrast sensitivity under glare conditions.
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Affiliation(s)
- Shady T Awwad
- Dept of Ophthalmology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9057, USA
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Du CX, Yang YB, Shen Y, Wang Y, Dougherty PJ. Bilateral Comparison of Conventional Versus Topographic-guided Customized Ablation for Myopic LASIK With the NIDEK EC-5000. J Refract Surg 2006; 22:642-6. [PMID: 16995545 DOI: 10.3928/1081-597x-20060901-04] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare visual acuity and higher order aberrations before and after myopic LASIK using conventional versus customized ablation. METHODS This prospective, randomized study included 54 myopic eyes in 27 patients who underwent bilateral LASIK using the NIDEK EC-5000 excimer laser system (NIDEK Technologies, Gamagori, Japan). Customized aspheric treatment zone (CATz) treatment was used in one eye (CATz group) and conventional ablation (conventional group) was used in the fellow eye. Uncorrected visual acuity (UCVA) and higher order aberrations (root-mean-square [RMS] in 4-mm and 6-mm zones) of both groups were observed with the NIDEK OPD-Scan aberrometer before and 3 months after LASIK. Preoperative mean refractive error was similar for both eyes of each patient (P>.05). RESULTS No statistically significant differences were noted in preoperative higher order aberrations (RMS in 4-mm and 6-mm zones) between groups (P>.05). No statistically significant difference was noted between pre- and postoperative higher order aberrations in the CATz group (P>.05). However, a highly statistically significant increase in higher order aberrations was observed after conventional ablation (P<.001). There was a statistically significant higher increase of higher order aberrations after LASIK in the conventional group than the CATz group (P<.05). Postoperative UCVA with both conventional and customized ablation was not significantly different (P>.05). CONCLUSIONS LASIK with conventional ablation and CATz ablation resulted in the same UCVA. The increase in higher order aberrations after CATz ablation was less than after conventional ablation.
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Affiliation(s)
- Chi-xin Du
- ZheYi Eye Center, The First Affiliated Hospital, Medical School, Zhejiang University, 79 Qingchun Rd, Hangzhou, Zhejiang, China 310003.
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Lombardo M, Lombardo G, Manzulli M, Palombi M, Serrao S. Relative Contribution of Central and Peripheral Aberrations to Overall High Order Corneal Wavefront Aberration. J Refract Surg 2006; 22:656-64. [PMID: 16995547 DOI: 10.3928/1081-597x-20060901-06] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To analyze the influence of specific combinations of corneal high order aberrations on the optical image quality of the cornea before and after photorefractive keratectomy (PRK) for low to high myopia and myopic astigmatism. METHODS Corneal topography was obtained for 80 eyes that underwent PRK using a scanning-spot excimer laser. The eyes were subdivided into three groups according to the preoperative refraction. The topographical data were imported into a custom software program that combined the Zernike high order terms having the same sign and angular frequency up to seventh order for 4-mm and 6-mm pupils, ie, coma and spherical aberrations, and midperipheral and peripheral high order aberrations. RESULTS Photorefractive keratectomy induced a significant amount of the root-mean-square (RMS) values of the combinations of midperipheral and peripheral high order aberrations over the smaller pupil size for deeper myopic ablations (P<.05). Over the larger pupil, spherical myopic ablations showed a significant increase (P<.05) of the RMS values of coma and spherical aberrations. In the astigmatism group, the combination of terms having higher angular frequency increased significantly (P<.05) after surgery both over 4-mm and 6-mm pupils. CONCLUSIONS After surface ablation, ablation depth and profile significantly influence the distribution and contribution of determined combinations of high order aberrations to the overall high order corneal wavefront aberration. Terms having high angular frequency were increased following large myopic correction and wide treatment zone. Quality of the whole corneal optics will be enhanced by designing future ablation profiles to compensate for peripheral high order optical aberrations.
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Netto MV, Dupps W, Wilson SE. Wavefront-guided ablation: evidence for efficacy compared to traditional ablation. Am J Ophthalmol 2006; 141:360-368. [PMID: 16458697 DOI: 10.1016/j.ajo.2005.08.034] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2005] [Revised: 08/18/2005] [Accepted: 08/18/2005] [Indexed: 11/20/2022]
Abstract
PURPOSE To provide an evidence-based overview of wavefront-guided refractive surgery outcomes, benefits, and limitations. DESIGN Literature review. METHODS Review of FDA study reports and indexed, peer-reviewed literature. RESULTS More than 400 reports investigating wavefront applications in refractive surgery exist, but studies comparing the outcomes of wavefront-guided treatment with conventional treatment are few in number. Available studies do not overwhelmingly demonstrate superior visual results attributable to a wavefront-guided approach. CONCLUSIONS While wavefront-guided refractive surgery provides excellent results, evidence is limited that it outperforms conventional laser in situ keratomileusis that incorporates broad ablation zones, smoothing to the periphery, eye-trackers, and other technological refinements. However, it is evident that wavefront-customized ablation holds a promising future and merits ongoing investigation.
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Affiliation(s)
- Marcelo V Netto
- The Cole Eye Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USA, and Department of Ophthalmology, University of São Paulo, São Paulo, Brazil
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Affiliation(s)
- Lewis R Groden
- Department of Ophthalmology, University of South Florida College of Medicine, MDC Box 21, 12901 Bruce B. Downs Boulevard, Tampa, FL 33612, USA
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Awwad ST, Haithcock KK, Oral D, Bowman RW, Cavanagh HD, McCulley JP. A Comparison of Induced Astigmatism in Conventional and Wavefront-guided Myopic LASIK Using LADARVision4000 and VISX S4 Platforms. J Refract Surg 2005; 21:S792-8. [PMID: 16329382 DOI: 10.3928/1081-597x-20051101-29] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate and compare the surgically induced astigmatism in myopic eyes undergoing conventional and wavefront-guided LASIK. METHODS A retrospective review was performed of the charts of 200 myopic eyes of 121 patients who underwent either custom or conventional treatments via the VISX S4 or LADARVision4000 platforms (50 consecutive eyes in each of the four groups). The primary outcome measure was manifest refraction, which was evaluated preoperatively and at 3 months postoperatively. The magnitude and axis of the unintended surgically induced astigmatism were calculated using vector analysis. The Student t test was used to compare the magnitudes of the surgically induced astigmatism and the absolute angle of error. RESULTS The mean preoperative manifest cylinder was 0.66 +/- 0.38 diopters (D) for conventional VISX S4 and 0.68 +/- 0.39 D for VISX CustomVue (P = .795), and 0.76 +/- 0.56 D for LADARVision and 0.61 +/- 0.36 D for LADAR CustomCornea (P = .114). The success index was 0.19 +/- 0.41 for VISX S4 and 0.49 +/- 0.49 for VISX CustomVue (P = .0013), and 0.25 +/- 0.47 for LADARVision and 0.20 +/- 0.39 for LADAR CustomCornea (P = .5721). The absolute mean angle of error was 4.4 +/- 13.9 degrees for VISX S4 versus 14.9 +/- 23.9 degrees for VISX CustomVue (P = .0085), and 6.1 +/- 12.30 for LADARVision versus 3.9 +/- 11.1 degrees for LADAR CustomCornea (P = .3501). Of the VISX CustomVue eyes, 32% had an absolute angle of error > 10 degrees, as compared to 10% for both the VISX S4 and LADAR CustomCornea eyes (P = .013), and 16% for the LADARVision group (P = .056). CONCLUSIONS Wavefront-guided ablation is associated with higher surgically induced astigmatism and larger astigmatic axis shift on the VISX platform as compared to the LADAR CustomCornea and the LADAR and VISX conventional platforms. Care should be emphasized mainly during registration/alignment to minimize surgically induced astigmatism in wavefront-guided LASIK.
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Affiliation(s)
- Shady T Awwad
- Dept of Ophthalmology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9057, USA
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Abstract
PURPOSE To quantify the higher order aberrations of refractive surgery candidates and compare the wavefront-determined refractions with manifest refractions refined with a +/- 0.25 Jackson cross cylinder. METHODS Results of 226 consecutive patients (418 eyes) were analyzed with the WaveScan WavePrint system (VISX, Santa Clara, Calif). Only patients with normal eyes without previous surgery were included. RESULTS The mean spherical equivalent refraction determined with wavefront analysis was -3.40 +/- 3.14 diopters (D) (range: -10.72 to +5.41 D). The largest amount of higher order aberrations was detected with : a 6-mm pupil diameter (coma 0.14 +/- 0.08 microm; trefoil 0.10 +/- 0.07 microm; spherical aberrations 0.09 +/- 0.07 microm). The mean root-mean-square of higher order aberrations and total aberrations were 0.23 +/- 0.11 microm and 4.00 +/- 2.45 microm, respectively. No statistically significant correlation was noted between higher order aberrations and gender (P = 0.7) or between higher order aberration and refractive level (P > .59). The mean differences in spherical equivalent refraction, sphere, and cylinder between WaveScan measurements and manifest refraction were 0.36 +/- 0.41 D, 0.40 +/- 0.44 D, and 0.28 +/- 0.32 D, respectively. CONCLUSIONS This study provides reference values for higher order aberrations in normal refractive surgery candidates. Wavefront analysis also proved to be a valuable tool for objectively measuring preoperative refractive error.
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Affiliation(s)
- Marcelo V Netto
- The Cole Eye Institute, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA
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Lee DH, Oh JR, Reinstein DZ. Conservation of corneal tissue with wavefront-guided laser in situ keratomileusis. J Cataract Refract Surg 2005; 31:1153-8. [PMID: 16039489 DOI: 10.1016/j.jcrs.2004.12.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2004] [Accepted: 10/19/2004] [Indexed: 10/25/2022]
Abstract
PURPOSE To determine whether corneal tissue can be conserved with wavefront-guided ablation compared to conventional surgery with a larger ablation zone for attempted prevention of glare and halo. SETTING Department of Ophthalmology, Ilsan Paik Hospital, Inje University, Korea. METHODS This prospective study was composed of 2 parts: First, 40 eyes of 20 patients were studied to determine whether a larger optical ablation could be beneficial in prevention of glare after conventional laser in situ keratomileusis (LASIK) surgery. One eye in each patient was treated with a 6.00 mm optical zone, and the other with a 6.25 mm optical zone. Second, 20 eyes of 10 patients with a higher-order root mean square (RMS) value of 0.3 or greater were evaluated to learn whether a wavefront-guided ablation could be as effective as a larger conventional optical ablation. One eye in each patient was treated by conventional LASIK surgery with a 6.25 mm optical zone, and the other eye was treated by wavefront-guided LASIK surgery with a 6.00 mm optical zone. All patients were analyzed with a WASCA analyzer (Carl Zeiss Meditec) preoperatively, and 1 month and 3 months after surgery. RESULTS Higher-order aberrations including coma, spherical aberration, and higher-order RMS were statistically significantly increased after conventional surgery with both a 6.00 mm and 6.25 mm optical zone. High-order aberrations including comaer- and spherical aberration after conventional surgery with 6.25 mm zone were statistically significantly increased. However, coma and higher-order RMS did not show a statistically significant increase between pre-LASIK and post-LASIK in wavefront-ablated eyes with a 6.00 mm optical zone. CONCLUSION Wavefront ablation showed less increase of coma and higher-order RMS regardless of a smaller optical zone. This finding might provide a clinical clue for an advantage of wavefront-guided ablation from the standpoint of corneal tissue conservation.
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Affiliation(s)
- Do-Hyung Lee
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University, Koyang, Korea.
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Abstract
PURPOSE The purpose of this article is to review the literature and find characteristics that lead to improved patient satisfaction and better quality of vision. RECENT FINDINGS Flatter preoperative corneal curvature is a risk factor for starbursts after laser-assisted in situ keratomileusis (LASIK). Pupil size has not been found to be correlated with night vision symptoms. Wavefront-guided ablations reduce higher-order aberrations in comparison with traditional LASIK. Night vision symptoms are correlated with younger age, greater correction/increased ablation depth, enhancement, and decreased ablation diameter. Contrast sensitivity has been found to initially decrease after LASIK, returning to baseline 6 to 12 months postoperatively. SUMMARY LASIK has quickly become the refractive procedure of choice around the world. Quality of vision and patient satisfaction after LASIK can be difficult to assess because of the many variables that must be considered to accurately measure these endpoints. Preoperative characteristics such as: increased patient age, decreased corneal toricity, or increased pupil size reduce patient satisfaction. Intraoperative factors like decentration, ablation-zone size, active eye tracking, and wavefront guided ablations affect quality of vision. Finally, postoperative factors such as night vision symptoms, reduced contrast sensitivity, and re-treatment can lead to a decline in patient satisfaction. Eliminating or limiting these variables may lead to increased patient satisfaction and higher quality of vision after LASIK.
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Affiliation(s)
- Stephen D Hammond
- Department of Ophthalmology, Medical College of Georgia, Augusta, Georgia, USA
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Wilson SE. Clinical practice. Use of lasers for vision correction of nearsightedness and farsightedness. N Engl J Med 2004; 351:470-5. [PMID: 15282354 DOI: 10.1056/nejmcp033210] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Steven E Wilson
- Cole Eye Institute, the Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
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Awwad ST, El-Kateb M, Bowman RW, Cavanagh HD, McCulley JP. Wavefront-guided Laser in situ Keratomileusis With the Alcon CustomCornea and the VISX CustomVue: Three-month Results. J Refract Surg 2004; 20:S606-13. [PMID: 15523984 DOI: 10.3928/1081-597x-20040901-38] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate and compare the visual and clinical outcomes of wavefront-guided laser in situ keratomileusis (LASIK) with the Alcon CustomCornea (Alcon Laboratories Inc, Fort Worth, Tex) and VISX CustomVue (VISX, Santa Clara, Calif) systems. METHODS Ninety-three eyes of 56 patients (50 and 43 consecutive eyes on CustomCornea and CustomVue, respectively) were enrolled in a prospective multisurgeon clinical outcome study. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and manifest refraction were measured at 1 day, 1 week, 1 month, and 3 months postoperatively. Early treatment diabetic retinopathy study (ETDRS) visual acuity and contrast sensitivity were measured at 1 month and 3 months, and wavefront mapping at 3 months. RESULTS Preoperatively, the CustomCornea group had a mean sphere of -3.90 +/- 1.62 diopters (D) (range -0.50 to -7.25 D), mean cylinder of +0.62 +/- 0.39 D (range 0 to +1.50 D), and mean manifest spherical equivalent refraction of -3.59 +/- 1.54 D. The CustomVue group had a sphere of -3.87 +/- 1.45 D (range -1.75 to -6.75 D), cylinder of +0.49 +/- 0.36 D (range 0 to +1.50 D), and manifest spherical equivalent refraction of -3.62 +/- 1.46 D. At 3 months, 98% of the CustomCornea group and 95% of the CustomVue group were within +/-0.50 D. Ninety-nine percent of eyes did not change >0.50 D (manifest spherical equivalent refraction) between 1 month and 3 months. CustomCornea eyes improved on contrast sensitivity testing and had a better profile than CustomVue for 20/15 Snellen and 20/12.5 ETDRS acuity. Both laser groups had a decrease in higher order aberrations with statistical significance for coma and spherical aberration in the CustomCornea group. CONCLUSION Wavefront-guided LASIK with both systems is safe and effective.
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Affiliation(s)
- Shady T Awwad
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9057, USA
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