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Saleh S, Epp LJ, Tran EMT, Manche EE. 12-Month Visual and Refractive Outcomes of Topography-guided Femtosecond Laser-Assisted LASIK for Myopia and Myopic Astigmatism. J Refract Surg 2024; 40:e595-e603. [PMID: 39254246 DOI: 10.3928/1081597x-20240717-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
PURPOSE To report 12-month visual and refractive outcomes following topography-guided femtosecond laser-assisted laser in situ keratomileusis (LASIK) for myopia and compound myopic astigmatism correction. METHODS This prospective, single-center observational study was conducted in an outpatient clinical practice at the Stanford University Byers Eye Institute in Palo Alto, California. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, 5% and 25% contrast sensitivity CDVA, and manifest refraction following topography-guided femtosecond laser-assisted LASIK were assessed. Refractive measurements were used to perform a vector analysis. RESULTS Sixty eyes of 30 patients (mean age: 32.8 ± 7.0 years; range: 23 to 52 years) undergoing topography-guided LASIK for the correction of myopia and compound myopic astigmatism were analyzed. Mean postoperative UDVA was -0.09 ± 0.10 logarithm of the minimum angle of resolution (logMAR) at 12 months. Mean preoperative CDVA was -0.09 ± 0.09 and -0.13 ± 0.08 logMAR at postoperative 12 months. At 12 months, 26.9% of eyes had gained one or more lines of postoperative UDVA compared to baseline CDVA. Mean pre-operative 5% contrast sensitivity CDVA was 0.68 ± 0.07 and 0.64 ± 0.12 logMAR at 12 months (P = .014) following LASIK. CONCLUSIONS Topography-guided LASIK for myopia and myopic astigmatism correction provided excellent visual and refractive outcomes that were predictable, precise, and stable up to 12 months postoperatively. [J Refract Surg. 2024;40(9):e595-e603.].
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Alves EM, Lyra AF, Tenório M, Mesquita N, Bacelar C, Montenegro A, Alves L, Alves M. Femtosecond laser-assisted in situ keratomileusis with topography-guided or asphericity-adjusted derived data: a comparative contralateral eye study. BMC Ophthalmol 2022; 22:189. [PMID: 35468752 PMCID: PMC9040263 DOI: 10.1186/s12886-022-02407-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 04/11/2022] [Indexed: 11/14/2022] Open
Abstract
Background Wavefront-optimized laser-assisted in situ keratomileusis (LASIK) ablation is the most commonly performed procedure in refractive surgery, but new technologies have become available. Our goal was to compare topography-guided (Contoura) and asphericity-guided (Custom-Q) customized ablation treatments for the correction of myopia with or without astigmatism. Methods This prospective, randomized, double-blind, contralateral eye study included 60 eyes of 30 patients with myopia or myopic astigmatism requiring femtosecond LASIK (FemtoLASIK) treatment. For each patient, one eye was randomized to undergo Contoura treatment, and the other underwent Custom-Q abaltion. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refractive spherical equivalent (MRSE), sphere (SPH), cylinder (CYL), 6.0-mm total corneal aberration root mean square (RMS), coma (COMA), trefoil (TREF), and spherical aberration (SA) were measured and analysed after a 1-year follow-up. Results The UDVA was − 0.08 ± 0.06 logMAR in Contoura eyes and − 0.08 ± 0.05 logMAR in Custom-Q eyes (p = 0.309) after 12 months. Twenty-five eyes (83%) in the Contoura group and twenty-six eyes (87%) in the Custom-Q group had a UDVA of 20/16 at the end of 12 months, and 100% of eyes in both groups reached a UDVA of 20/25 or better. Ninety and 100% of eyes in the Contoura and Custom-Q groups, respectively, achieved a residual CYL ≤0.50 D (p = 0.237). No statistically significant difference was observed between the surgical techniques in the preoperative to 1-year postoperative changes for any of the parameters evaluated (MRSE, CYL, RMS, DEF, COMA, TREF, and SA). Conclusions The Contoura and Custom-Q techniques yielded excellent visual and refractive results, but the evidence did not reveal any clear differences between these two methods after 1 year of follow-up. Trial registration ReBEC - Registro Brasileiro de Ensaios Clínicos [Internet]: Rio de Janeiro (RJ): Instituto de Informação Científica e Tecnológica em Saúde (Brazil); 2010 -. Identifier RBR-8rs5kt Myopia and Astigmatism Topography-guided Refractive Surgery by Contoura Method Versus Customized by Asphericity in Contralateral Eyes: A prospective Double blind Randomized Study. Available from https://ensaiosclinicos.gov.br/rg/RBR-8rs5kt Date of registration: 02/03/2020 (dd/mm/yyyy). CAAE:96778718.9.0000.5192. Issuing authority: Plataforma Brasil. CEP:2.979.279. Issuing authority: HUOC.
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Affiliation(s)
- Ermano M Alves
- Oftalmax, Rua Benfica, 411, Madalena, Recife, PE, 50720-001, Brazil.
| | - Adriana F Lyra
- Hospital Santa Luzia, Estrada do Encanamento, 909, Casa Forte, Recife, PE, Brazil
| | - Manuela Tenório
- Oftalmax, Rua Benfica, 411, Madalena, Recife, PE, 50720-001, Brazil
| | - Natália Mesquita
- Oftalmax, Rua Benfica, 411, Madalena, Recife, PE, 50720-001, Brazil
| | - Carolina Bacelar
- Hospital Santa Luzia, Estrada do Encanamento, 909, Casa Forte, Recife, PE, Brazil
| | - Afra Montenegro
- Oftalmax, Rua Benfica, 411, Madalena, Recife, PE, 50720-001, Brazil
| | | | - Márcio Alves
- FPS-IMIP, Av Mal. Mascarenhas de Morais, Recife, PE, 4861, Brazil
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Cheng SM, Tu RX, Li X, Zhang JS, Tian Z, Zha ZW, Ruan KW, Yu AY. Topography-Guided Versus Wavefront-Optimized LASIK for Myopia With and Without Astigmatism: A Meta-analysis. J Refract Surg 2021; 37:707-714. [PMID: 34661478 DOI: 10.3928/1081597x-20210709-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the differences in efficacy, predictability, safety, and visual quality between topography-guided customized ablation treatment (TCAT) and wavefront-optimized (WFO) laser in situ keratomileusis (LASIK) for the treatment of myopia with and without astigmatism. METHODS A comprehensive literature search of PubMed, Embase, the Cochrane library, Web of Science, and ClinicalTrials was used to identify randomized controlled trials (RCTs) comparing TCAT-LASIK with WFO-LASIK for myopia with and without astigmatism up to September 2020. The references of all searched literature were checked as supplements. Literature was screened according to the inclusion and exclusion criteria and relative data were extracted. RevMan software version 5.3.0 (Cochrane Collaboration) was used for meta-analysis. RESULTS A total of seven RCTs (1,168 eyes) were included. There were no statistically significant differences in the ratio of uncorrected distance visual acuity of 20/20 or better (relative risk [RR] = 1.01, 95% CI [0.97 to 1.06], P = .64) and 20/16 or better (RR = 0.96, 95% CI [0.80 to 1.16], P = .69). Compared with WFO-LASIK, TCAT-LASIK achieved a higher proportion of postoperative manifest refractive spherical equivalent within ±0.50 diopters of the target (RR = 1.06, 95% CI [1.02 to 1.11], P = .003) and less surgically induced higher order aberrations (weighted mean difference [WMD] = -0.11, 95% CI [-0.15 to -0.0], P < .00001), spherical aberrations (WMD = -0.04, 95% CI [-0.05 to -0.03], P < .00001), and coma (WMD = -0.15, 95% CI [-0.28 to -0.01], P = .03). No patient lost two or more lines of distance-corrected visual acuity postoperatively in the two groups. CONCLUSIONS This meta-analysis suggests that both TCATLASIK and WFO-LASIK show excellent efficacy, predictability, and safety for myopia. TCAT-LASIK exhibited more accurate postoperative refraction predictability and less surgically induced higher order aberrations, spherical aberrations, and coma. More randomized, prospective, and large sample-sized studies are needed to confirm these conclusions in the long term. [J Refract Surg. 2021;37(10):707-714.].
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Ramamurthy S, Soundarya B, Sachdev GS. Topography-guided treatment in regular and irregular corneas. Indian J Ophthalmol 2020; 68:2699-2704. [PMID: 33229645 PMCID: PMC7857005 DOI: 10.4103/ijo.ijo_2119_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Over the last decade, refractive surgery has been revolutionized by advancements in ablation profiles, available for the treatment of both regular and irregular corneas. Advances in corneal imaging have helped highlight the presence of higher-order aberrations, the correction of which could result in a better quality of vision. Topographic measurements being static are more repeatable and pupil independent and therefore provide the ideal platform for correction of both lower and higher-order aberrations and could result in improved visual quality even in patients with seemingly regular corneas. The combination of topography-guided treatment with collagen cross-linking has further increased the scope of treating irregular corneas like keratoconus, post-laser in-situ keratomileusis ectasia, and pellucid marginal degeneration. This review delves into the current literature and guidelines available for the topographic treatment of regular and irregular corneas.
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Affiliation(s)
| | - B Soundarya
- The Eye Foundation, Coimbatore, Tamil Nadu, India
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Shin E, Yoo YS, Choi SH, Han SH, Lim DH, Yoon GJ, Chung TY. Clinical outcomes of topography-guided femtosecond laser-assisted in situ keratomileusis after multifocal intraocular lens implantation. Sci Rep 2020; 10:10666. [PMID: 32606388 PMCID: PMC7326976 DOI: 10.1038/s41598-020-67726-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/15/2020] [Indexed: 11/24/2022] Open
Abstract
This retrospective study is to evaluate refractive and visual outcomes of topography-guided femtosecond laser-assisted in situ keratomileusis (TGL) for correcting corneal high-order aberrations (HoA) after multifocal intraocular lens (mIOL) implantation. Twenty-eight eyes of 28 patients with both corrected distance visual acuity (CDVA) under 20/25 and subjective visual discomfort at 3 months after mIOL implantation were included in the study. TGL was performed to correct corneal HoA. Visual acuity, manifest refraction, and corneal HoA were measured 3 months after TGL. CDVA was improved in 22 (78.57%) of 28 eyes after TGL. Uncorrected distance visual acuity (0.12 ± 0.16 logMAR) and uncorrected near visual acuity (0.081 ± 0.16 logMAR) were better than those before TGL (P < 0.001). Residual refractive astigmatism showed no difference compared to that before TGL. Root mean square (RMS) of HoA (P = 0.012), spherical aberration (P = 0.013), and RMS of coma (P = 0.001) were reduced relative to those before TGL. Amount of improvement in CDVA was correlated with amount of reduced coma RMS (R = 0.524; P = 0.005) and spherical aberration (R = 0.443; P = 0.021). TGL showed to improve both refractive and visual outcomes in patients with mIOL implantation by correcting corneal HoA.
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Affiliation(s)
- Eunhae Shin
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Young-Sik Yoo
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.,Department of Ophthalmology, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Gyeonggi-do, Republic of Korea
| | - Sung-Ho Choi
- BALGEUN-EYE21 Hospital, Gwangju, Republic of Korea.
| | - Sun-Hyup Han
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.,Department of Medical Device Management and Research, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | - Tae-Young Chung
- Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
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Analysis of planning strategies in primary eyes gaining a line or more of visual acuity after topography-guided laser in situ keratomileusis. J Cataract Refract Surg 2019; 45:321-327. [PMID: 30733106 DOI: 10.1016/j.jcrs.2018.10.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/17/2018] [Accepted: 10/10/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To analyze planning strategies for eyes that gained 1 or more lines of corrected distance visual acuity (CDVA) after topography-guided custom treatment (TCAT). SETTING Refractive Surgery Clinic, Cleveland Clinic, Ohio, USA. DESIGN Retrospective case series. METHODS Eyes having TCAT by the same surgeon between February 2016 and June 2017 were enrolled. The corneal shape was captured with the Wavelight Allegretto Topolyzer diagnostic device coupled with refraction, generating an ablation profile. The cylinder magnitude and axis of laser entry were decided by the surgeon based on the manifest and measured values, assisted by additional data from the Pentacam Scheimpflug tomographer and Ladarwave ocular wavefront aberrometer. RESULTS The study comprised 256 eyes. At 3 months, uncorrected distance visual acuity was 20/20 or better in 95.7% and 20/15 or better in 81.4%; 25.6% gained 1 or more lines of CDVA. The measured and manifest axes differed by less than 15 degrees in 59%, between 15 degrees and 30 degrees in 18%, and by more than 30 degrees in 23%. When it differed by at least 5 degrees, the measured axis was treated in 79%, 75%, and 73% of eyes, respectively. In eyes with higher measured cylinder, 75% were treated between the manifest and measured values, with 7% at full measured value. When the manifest value was greater, 60% were treated at the total measured value and 40% in between. Whole-eye aberrometry showed a small increase in coma, spherical aberration and the total root mean square (all P < .001). CONCLUSIONS The TCAT procedure achieved visual acuity better than the preoperative CDVA in more than 25.0% of eyes. Tomography and wavefront aberrometry assisted in the selection process to achieve optimum visual outcomes.
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Tiwari NN, Sachdev GS, Ramamurthy S, Dandapani R. Comparative analysis of visual outcomes and ocular aberrations following wavefront optimized and topography-guided customized femtosecond laser in situ keratomileusis for myopia and myopic astigmatism: A contralateral eye study. Indian J Ophthalmol 2018; 66:1558-1561. [PMID: 30355860 PMCID: PMC6213678 DOI: 10.4103/ijo.ijo_507_18] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: To compare the visual outcomes and higher order aberrations (HOAs) following wavefront optimized (WFO) laser in situ keratomileusis (LASIK) versus topography-guided customized ablation (TCAT) LASIK for myopia and myopic astigmatism. Methods: Patients who underwent femtosecond-assisted LASIK for myopic correction between August 2016 and October 2017 were included in this interventional prospective case series. The following parameters were evaluated preoperatively and at 3 months’ postoperative visit: uncorrected distance vision acuity (UDVA) and corrected distance vision acuity (CDVA), manifest refraction, and HOAs. Results: Two hundred eyes of 100 patients were included in the study. At 3 months’ postoperative visit, 92% and 90% eyes in the TCAT and WFO groups, respectively, demonstrated a UDVA of 20/20 or better (P = 0.90). A residual manifest spherical equivalent within 0.5 D was achieved in 100% and 95% of the eyes in the TCAT and WFO groups, respectively (P = 0.10). No significant difference was observed in the HOAs induced in both the groups, with slightly lower induction of trefoil and horizontal coma in the TCAT group. Conclusion: Both groups demonstrated similar refractive efficacy and predictability, with greater gain of CDVA following TCAT ablation. HOAs induced were not significantly different between the two groups. Further studies are needed to validate the superiority of one procedure over the other.
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Affiliation(s)
- Nitin N Tiwari
- Department of Cornea and Refractive Services, The Eye Foundation, 582A, DB Road, RS Puram, Coimbatore, Tamil Nadu, India
| | - Gitansha S Sachdev
- Department of Cornea and Refractive Services, The Eye Foundation, 582A, DB Road, RS Puram, Coimbatore, Tamil Nadu, India
| | - Shreyas Ramamurthy
- Department of Cornea and Refractive Services, The Eye Foundation, 582A, DB Road, RS Puram, Coimbatore, Tamil Nadu, India
| | - Ramamurthy Dandapani
- Department of Cornea and Refractive Services, The Eye Foundation, 582A, DB Road, RS Puram, Coimbatore, Tamil Nadu, India
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Jain AK, Malhotra C, Pasari A, Kumar P, Moshirfar M. Outcomes of topography-guided versus wavefront-optimized laser in situ keratomileusis for myopia in virgin eyes. J Cataract Refract Surg 2018; 42:1302-1311. [PMID: 27697248 DOI: 10.1016/j.jcrs.2016.06.035] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 05/24/2016] [Accepted: 06/29/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the outcomes of topography-guided and wavefront-optimized treatment in patients having laser in situ keratomileusis (LASIK) for myopia. SETTING Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India. DESIGN Prospective contralateral-eye case study. METHODS Patients had topography-guided LASIK in 1 eye and wavefront-optimized LASIK in the contralateral eye using the Customized Refractive Surgery Master software and Mel 80 excimer laser. Refractive (residual manifest refraction spherical equivalent [MRSE], higher-order aberrations [HOAs]), and visual (uncorrected distance visual acuity [UDVA] and photopic and mesopic contrast sensitivity) outcomes were prospectively analyzed 6 months postoperatively. RESULTS The study comprised 35 patients. The UDVA was 0.0 logMAR or better and the postoperative residual MRSE was ±0.50 diopter in 94.29% of eyes in the topography-guided group and 85.71% of eyes in the wavefront-optimized group (P = .09). More eyes in the topography-guided group than in the wavefront-optimized group had a UDVA of -0.1 logMAR or better (P = .04). Topography-guided LASIK was associated with less deterioration of mesopic contrast sensitivity at higher spatial frequencies (12 cycles per degree [cpd] and 18 cpd) and lower amounts of induced coma (P = .04) and spherical aberration (P = .04). Less stromal tissue was ablated in the topography-guided group (mean 61.57 μm ± 16.23 [SD]) than in the wavefront-optimized group (mean 79.71 ± 14.81 μm) (P < .001). CONCLUSION Although topography-guided LASIK and wavefront-optimized LASIK gave excellent results, topography-guided LASIK was associated with better contrast sensitivity, lower induction of HOAs, and a smaller amount of tissue ablation. FINANCIAL DISCLOSURE None of the authors has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Arun Kumar Jain
- From the Advanced Eye Centre (Jain, Malhotra, Parasi, Kumar), Post Graduate Institute of Medical Education and Research, Chandigarh, India; the Department of Ophthalmology (Moshirfar), Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
| | - Chintan Malhotra
- From the Advanced Eye Centre (Jain, Malhotra, Parasi, Kumar), Post Graduate Institute of Medical Education and Research, Chandigarh, India; the Department of Ophthalmology (Moshirfar), Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA
| | - Anand Pasari
- From the Advanced Eye Centre (Jain, Malhotra, Parasi, Kumar), Post Graduate Institute of Medical Education and Research, Chandigarh, India; the Department of Ophthalmology (Moshirfar), Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA
| | - Pawan Kumar
- From the Advanced Eye Centre (Jain, Malhotra, Parasi, Kumar), Post Graduate Institute of Medical Education and Research, Chandigarh, India; the Department of Ophthalmology (Moshirfar), Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA
| | - Majid Moshirfar
- From the Advanced Eye Centre (Jain, Malhotra, Parasi, Kumar), Post Graduate Institute of Medical Education and Research, Chandigarh, India; the Department of Ophthalmology (Moshirfar), Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA
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Refractive Errors & Refractive Surgery Preferred Practice Pattern®. Ophthalmology 2018; 125:P1-P104. [DOI: 10.1016/j.ophtha.2017.10.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 11/19/2022] Open
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Shetty R, Shroff R, Deshpande K, Gowda R, Lahane S, Jayadev C. A Prospective Study to Compare Visual Outcomes Between Wavefront-optimized and Topography-guided Ablation Profiles in Contralateral Eyes With Myopia. J Refract Surg 2017; 33:6-10. [PMID: 28068440 DOI: 10.3928/1081597x-20161006-01] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 09/01/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To analyze refractive outcomes of wavefront-optimized (WFO) ablation and topography-guided custom ablation (TCAT) profiles using the Allegretto Wave excimer laser platform (Alcon Laboratories, Inc., Fort Worth, TX) in the treatment of myopia. METHODS Sixty eyes of 30 patients who underwent LASIK were included in this prospective interventional study. WFO ablation was performed in one eye (WFO group) and TCAT in the fellow eye (TCAT group). The WaveLight FS200 femtosecond laser (Alcon Laboratories, Inc.) was used to create the flap and Allegretto Wave excimer laser (Alcon Laboratories, Inc.) was used for photoablation. The Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) and Allegretto Topolyzer (Alcon Laboratories, Inc.) were used to measure the corneal aberrations. Refractive visual outcomes were also compared. RESULTS Accuracy, safety, and efficacy were similar in the two groups. The total root mean square (RMS) and RMS of lower order aberrations were significantly better in eyes that underwent TCAT (P < .05). There was a decrease in individual higher order aberrations in the TCAT group, with a statistically significant difference in the spherical aberrations (P = .02). The corneal asphericity (Q value) was not significantly different between the WFO (0.6 ± 0.1) and TCAT (0.51 ± 0.09) groups. The postoperative total RMS of higher order aberrations was lower in the TCAT group, but this was not statistically significant (P > .05). There was a more positive change in Q value and spherical aberrations in the WFO group, but this was not statistically significant. CONCLUSIONS TCAT and WFO ablation provided essentially equivalent outcomes after myopic LASIK, with induction of fewer lower order aberrations and higher order aberrations following TCAT ablation. [J Refract Surg. 2017;33(1):6-10.].
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Toda I, Ide T, Fukumoto T, Tsubota K. Visual Outcomes After LASIK Using Topography-Guided vs Wavefront-Guided Customized Ablation Systems. J Refract Surg 2016; 32:727-732. [DOI: 10.3928/1081597x-20160718-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 06/23/2016] [Indexed: 11/20/2022]
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Abstract
PURPOSE OF REVIEW Topography-guided laser refractive surgery regularizes the front corneal surface irregularities to achieve the desired refractive outcome. This is particularly applicable in highly aberrated corneas, where wavefront aberrometry is often not possible. This article aims to review the recently published results of topography-guided ablations in normal regular corneas, highly aberrated corneas, and its application in conjunction with collagen cross-linking (CXL) in cases of keratectasia. RECENT FINDINGS Topography-guided laser ablation is increasingly used with good efficacy and safety outcomes in highly aberrated corneas with irregular astigmatism. These include eyes with refractive surgery complications including postlaser in-situ keratomileusis ectasia, decentered ablation, small optical zones, asymmetrical astigmatism, and postradial keratectomy astigmatism. Further indications are for postkeratoplasty astigmatism and keratoconus. Simultaneous topography-guided ablations with CXL in keratectasia have been promising, both in addressing the surface irregularities and progressive nature of the conditions. SUMMARY Topography-guided laser refractive surgery is proving to be effective and well tolerated in the visual rehabilitation of highly aberrated eyes, with increasing predictability based on the recent research.
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Tan J, Simon D, Mrochen M, Por YM. Clinical results of topography-based customized ablations for myopia and myopic astigmatism. J Refract Surg 2013; 28:S829-36. [PMID: 23447897 DOI: 10.3928/1081597x-20121005-04] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate clinical outcomes after primary treatments for myopia and myopic astigmatism with topography-based ablation profiles on the Allegretto Wave Eye-Q platform (Alcon Laboratories Inc). METHODS Records of patients who underwent topography-guided, Q-adjusted LASIK were retrieved and analyzed. Patients with mean refractive spherical equivalent up to -16.00 diopters (D) and cylindrical errors up to 6.00 D were included (2051 eyes). Refractive outcomes and visual acuities were analyzed preoperatively and 3 months postoperatively. RESULTS Manifest spherical refractive error decreased from -5.05 +/- 2.33 to +0.04 +/- 0.35 D. Manifest cylindrical refractive error decreased from 0.83 +/- 0.75 to 0.23 +/- 0.22 D. At 3 months postoperatively, 86.1% (1766 eyes) had a spherical equivalent refraction within +/- 0.50 D of targeted refraction. The number of eyes with uncorrected distance visual acuity of 20/16 and 20/20 was 851 (41.5%) and 1495 (72.9%), respectively. At 3 months, 0.10% (2 eyes) lost more than 2 lines of corrected distance visual acuity and a loss of 2 lines occurred in 0.24% (5 eyes). All patients who lost lines of visual acuity were found to have corneal erosions related to dryness and recovered vision on further follow-up. CONCLUSIONS The results of this retrospective study demonstrate refractive predictability, efficacy, and safety comparable to other treatment modalities such as wavefront-optimized and wavefront-guided treatments. Results are also similar to those reported with other topography-guided systems.
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AlMahmoud T, Munger R, Jackson WB. Advanced corneal surface ablation efficacy in myopia: changes in higher order aberrations. Can J Ophthalmol 2011; 46:175-81. [PMID: 21708087 DOI: 10.3129/i10-104] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To evaluate the change of ocular and corneal higher order aberrations (HOAs) after wavefront-guided advanced surface ablation (WF-ASA) for myopia using 4 different epithelial management techniques (AA-PRK, LASEK, Epi-PRK, and Epi-LASIK). DESIGN Retrospective single centre excimer database analysis. PARTICIPANTS Two hundred and forty eyes equally divided between the 4 WF-ASA techniques, matched for mean and range of required spherical correction. METHODS Ocular wavefront aberrations were measured using the wavescan aberrometer and corneal aberrations were obtained from corneal topography elevation maps and calculated by ray-tracing. All data were collected preoperatively and 3 months following treatment. The aberrations were described as Zernike polynomials, and analysis focused on total HOAs and spherical aberration (SA). RESULTS Three months postoperatively, there was a statistically significant surgically induced increase in total HOAs and SA both for ocular and corneal analysis (p < 0.001). There was no statistically significant difference in the induced ocular SA and HOAs between the groups, but the differences in induced corneal SA and HOAs were significant (p < 0.010). Ocular changes in SA were weakly correlated to preoperative SA (20.30, p < 0.001) but strongly correlated to applied spherical correction (20.68, p < 0.001). Surgically induced corneal SA was weakly correlated to preoperative corneal SA (20.34, p < 0.001) and applied spherical correction (20.46, p < 0.001). CONCLUSIONS Three months postoperatively, all procedures resulted in an increase in ocular and cornealHOAs and SA. Induced aberrations were most strongly correlated to the applied spherical power correction. Modifying the existing ablation pattern to compensate for induced HOAs might improve the outcome.
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Affiliation(s)
- Tahra AlMahmoud
- Department of Surgery, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE.
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Falavarjani KG, Hashemi M, Modarres M, Sanjari MS, Darvish N, Gordiz A. Topography-Guided vs Wavefront-Optimized Surface Ablation for Myopia Using the WaveLight Platform: A Contralateral Eye Study. J Refract Surg 2011; 27:13-7. [DOI: 10.3928/1081597x-20100310-02] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Accepted: 02/09/2010] [Indexed: 11/20/2022]
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Kugler L, Cohen I, Haddad W, Wang MX. Efficacy of laser in situ keratomileusis in correcting anterior and non-anterior corneal astigmatism: comparative study. J Cataract Refract Surg 2010; 36:1745-52. [PMID: 20870122 DOI: 10.1016/j.jcrs.2010.05.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 04/28/2010] [Accepted: 05/06/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare the efficacy of conventional laser in situ keratomileusis (LASIK) in treating corneal astigmatism and in treating noncorneal ocular residual astigmatism. SETTING Private practice, Nashville, Tennessee, USA. DESIGN Retrospective case series. METHODS The records of dominant eyes of consecutive patients who had LASIK were retrospectively analyzed to compare the efficacy of LASIK in eyes with predominantly anterior corneal astigmatism with the efficacy in eyes with predominantly ocular residual astigmatism (ORA). The ORA was determined by vector analysis using refractive cylinder and topographic astigmatism. Preoperatively, the ratio of ORA to preoperative refractive cylinder (R) was used to divide the patients into 2 groups; that is, eyes with predominantly anterior corneal astigmatism (ORA/R ratio <1.0) and eyes with predominantly ORA (ORA/R ratio ≥1.0). Efficacy was determined by examining the magnitude of the remaining uncorrected astigmatism and comparing the index of success (proportion of preoperative refractive astigmatism that remained uncorrected by LASIK) between the 2 groups. RESULTS The study evaluated 61 eyes of 61 patients. Conventional LASIK was twice as efficacious in the low-ORA group as in the high-ORA group. The index of success was 0.24 and 0.50, respectively, and the difference between groups was statistically significant (P = .036). CONCLUSION The efficacy of astigmatic correction by LASIK was significantly higher in eyes in which the preoperative refractive astigmatism was located mainly on the anterior corneal surface than in eyes in which it was mainly located posterior to the anterior corneal surface.
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Affiliation(s)
- Lance Kugler
- Wang Vision Institute, Nashville, Tennessee, USA.
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Ang RET, Chan WK, Wee TL, Lee HM, Bunnapradist P, Cox I. Efficacy of an aspheric treatment algorithm in decreasing induced spherical aberration after laser in situ keratomileusis. J Cataract Refract Surg 2009; 35:1348-57. [PMID: 19631119 DOI: 10.1016/j.jcrs.2009.03.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 02/13/2009] [Accepted: 03/12/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE To determine the effectiveness of an aspheric laser in situ keratomileusis (LASIK) algorithm for myopia with and without astigmatism in minimizing postoperative induction of spherical aberration. SETTING Four sites in Asia. METHODS Patients with -1.00 to -10.00 diopters (D) of spherical myopia with -4.00 D or less of astigmatism were recruited. Patients randomly had bilateral Zyoptix aspheric algorithm (aspheric group) or bilateral conventional Zyoptix Tissue Saving algorithm (control group). A Technolas 217z100 excimer system was used for LASIK ablation. Visual effectiveness, safety, higher-order aberrations, and corneal asphericity (Q value) were evaluated postoperatively. RESULTS The aspheric group comprised 86 eyes and the control group, 84 eyes. At 3 months, the high-contrast uncorrected distance visual acuity was 20/20 or better in 78% of eyes in the aspheric group and 83% of eyes in the control group. The control treatment induced 0.22 microm of spherical aberration, which was significantly higher than the 0.04 microm induced with the aspheric treatment (6.0 mm pupil) (P<.0001). The aspheric treatment induced significantly less vertical coma and trefoil (P = .02). Eyes in the aspheric group had significantly lower Q values (P<.0001). There was no statistically significant difference in the manifest refraction spherical equivalent between the 2 groups (P >.05). Although high- and low-contrast corrected distance visual acuity (CDVA) was similar between the groups, the aspheric group gained more lines of low-contrast CDVA. CONCLUSION The aspheric algorithm was more effective than the conventional algorithm in reducing induced spherical aberration and maintaining corneal asphericity after myopic LASIK.
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Arbelaez MC, Vidal C, Jabri BA, Mosquera SA. LASIK for Myopia with Aspheric “Aberration Neutral” Ablations Using the ESIRIS Laser System. J Refract Surg 2009; 25:991-9. [DOI: 10.3928/1081597x-20091016-04] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2008] [Accepted: 10/24/2008] [Indexed: 11/20/2022]
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Dougherty PJ, Waring G, Chayet A, Fischer J, Fant B, Bains HS. Topographically guided laser in situ keratomileusis for myopia using a customized aspherical treatment zone. J Cataract Refract Surg 2008; 34:1862-71. [DOI: 10.1016/j.jcrs.2008.07.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2007] [Accepted: 07/22/2008] [Indexed: 10/21/2022]
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Alpins N, Stamatelatos G. Clinical outcomes of laser in situ keratomileusis using combined topography and refractive wavefront treatments for myopic astigmatism. J Cataract Refract Surg 2008; 34:1250-9. [DOI: 10.1016/j.jcrs.2008.03.028] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Accepted: 03/28/2008] [Indexed: 11/28/2022]
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