Safety and Effectiveness of Laser in Situ Keratomileusis Using the Teneo 317 Model 2 for Correcting Myopia and Myopic Astigmatism: Results of the U.S. FDA Clinical Trial

PURPOSE

To evaluate the safety and effectiveness of a new aspheric ablation profile for correcting myopia and myopic astigmatism.

METHODS

This prospective, multicenter study included patients who underwent laser in situ keratomileusis (LASIK) using a new aspheric ablation profile of the Technolas Teneo 317 (Model 2) excimer laser (version 1.28 US SW) by Technolas Perfect Vision, Bausch+Lomb, Inc. No nomogram adjustments were made, and the patient's manifest refraction was entered into the laser (for treatment). Postoperative assessments included visual and refractive outcomes. Patients were asked to complete the Patient-Reported Outcomes With LASIK (PROWL) questionnaire preoperatively and postoperatively.

RESULTS

A total of 333 eyes from 168 patients with a mean age of 33 ± 7 years were included. At postoperative 9 months, uncorrected and corrected distance visual acuities of 20/25 or better were seen in 97.8% and 100% of eyes, respectively. None of the eyes lost two or more lines of corrected distance visual acuity. The mean manifest spherical refraction improved from -5.67 ± 2.52 diopters (D) preoperatively to -0.04 ± 0.32 D postoperatively, with 92.7% of eyes achieving residual refractive error within ±0.50 D. Residual refractive cylinder within ±0.50 and ±1.00 D was seen in 93% and 99.4% eyes, respectively. The refractive outcomes were stable throughout the follow-up of 9 months. The proportion of patients satisfied with their vision rose from 27.7% preoperatively to 98.1% postoperatively.

CONCLUSIONS

LASIK performed using a new aspheric ablation profile of the Technolas Teneo 317 (Model 2) excimer laser is safe and effective for correcting myopia and myopic astigmatism, yielding excellent visual and refractive outcomes that were stable over 9 months. [J Refract Surg. 2024;40(8):e544-e553.].

Outcomes for Mixed Cylinder LASIK With the MEL 90® Excimer Laser

PURPOSE

To report the outcomes of LASIK for mixed cylinder using the Triple-A ablation profile with the MEL 90 excimer laser (Carl Zeiss Meditec, Jena, Germany).

METHODS

This was a retrospective analysis of all eyes treated by LASIK for mixed cylinder using the Triple-A ablation profile with the MEL 90 laser between July 2013 and October 2016. Patients were observed for 1 year after surgery. Standard outcomes analysis and vector analysis by the Alpins method were performed.

RESULTS

The database review identified 105 eyes (82 patients) treated by LASIK for mixed cylinder using the MEL 90 laser. Mean age was 40 ± 11 years (range: 18 to 65 years). Mean attempted spherical equivalent was +0.30 ± 0.90 diopters (D) (range: -2.30 to +1.75 D). Mean cylinder was -2.93 ± 1.47 D (range: -0.75 to -7.00 D). Preoperative corrected distance visual acuity (CDVA) was 20/20 or better in 81% of eyes. Postoperative uncorrected distance visual acuity was 20/20 or better in 69% and 20/25 or better in 86% of eyes. Mean postoperative spherical equivalent relative to the intended target was -0.21 ± 0.38 D (range: -1.25 to +1.13 D), with 83% within ±0.50 D. Mean postoperative cylinder was -0.57 ± 0.41 D (range: 0.00 to -1.75 D). Geometric mean was 1.12 for the correction index and 0.25 for the index of success. For angle of error, the arithmetic mean was -0.6° ± 4.2° (range: -13.5° to 9.5°) and the absolute mean was 2.9° ± 3.0° (range: 0.0° to 13.5°). There was loss of one line of CDVA in 3% of eyes and no eyes lost two or more lines CDVA. There was a small increase in contrast sensitivity after surgery at 3, 6, 12, and 18 cycles per degree (P < .05).

CONCLUSIONS

One-year outcomes of LASIK using the MEL 90 laser for mixed cylinder up to -7.00 D demonstrated excellent efficacy, safety, and predictability. Vector analysis found a 12% overcorrection in magnitude of refractive cylinder. Given the high accuracy for angle of error, a nomogram could be applied to reduce the over-correction and further improve the uncorrected distance visual acuity outcomes. [J Refract Surg. 2018;34(10):672-680.].

Excimer Lasers in Refractive Surgery

Introduction

In the field of ophthalmology, laser technology is used in many basic and clinical disciplines and specialities. It has played an important role in promoting the development of ophthalmology.

Aim

This article is designed to review the evolution of laser technology in refractive surgeries in ophthalmology, mainly focusing on the characteristics of the excimer laser applied in corneal refractive surgery.

Methods

This article was performed based on a literature review and Internet search through scientific databases such as PubMed, Scopus, Web of Science and Google Scholar.

Result

The literature on excimer laser technology addresses the technical and physical aspects of excimer lasers including types, characteristics and commercially available lasers on the market.

Conclusion

The conclusion on this forum aims to help understand the benefits of excimer laser use in ophthalmology, with focus on correction of refractive errors.

Predictive Factors for Successful High Myopia Treatment Using High-Frequency Laser-In-Situ Keratomileusis

Aim

To evaluate the predictive factors of LASIK procedure for high myopia with or without astigmatism using a combination of high-frequency femtosecond-assisted LASIK followed by an excimer laser.

Methods

This study was a retrospective interventional case series study to evaluate myopic eyes undergoing high platform LASIK with FEMTO LDV Z2 intervention, followed by WaveLight®EX500 excimer laser machine. Subjects were divided into 2 groups: high myopia (SE of -6.01 to -9.00 D) and very high myopia (SE of -9.01 D or higher). Myopic eyes (Spherical Equivalent/SE) less than -13 D were included in this study. Visual Acuity (VA) was evaluated 1 day and 60 days after the procedure. Predictive factors, such as age, degree of sphere, degree of astigmatism, keratometric reading and axial length were analyzed to detect any influences affecting the final VA results.

Results

A total of 316 myopia eyes underwent intervention, mean age: 25.3±3.8 years. Target treatment was achieved in 96.1% of patients with high myopia and 69.9% of patients with very high myopia. High degree of sphere and astigmatism constitutes an important factor influencing final VA.

Conclusion

Modern machines provide a more promising efficacy and success of LASIK procedure in high myopia: important predictive factors were a high degree of sphere and astigmatism for achieving the optimal final outcome.

Comparison of Wavelight Allegretto Eye-Q and Schwind Amaris 750S excimer laser in treatment of high astigmatism

Purpose

To compare functional outcomes of Wavelight Allegretto Eye-Q 400Hz and Schwind Amaris 750S excimer laser for astigmatism between 2 and 7 diopters(D).

Methods

Prospective comparative non-randomized case series of 480 eyes assigned in two laser groups and further divided into myopic and mixed astigmatism subgroups. All treatments were centered on corneal vertex. One-year results were compared between the groups. Statistical analysis was performed using z-test.

Results

Both Allegretto and Amaris postoperative uncorrected distance visual acuity (UDVA) improved in comparison to preoperative corrected distance visual acuity (CDVA). The difference was significant in the Allegretto group for myopic astigmatism (p = 0.017). There was no difference in postoperative UDVA between lasers. Average sphere decreased in all groups for both lasers (p < 0.001) without difference in effectiveness of spherical correction between lasers for both groups. In Allegretto, average cylinder decreased from −3.30D to −0.55D in myopic astigmatism (p < 0.001) and from −3.84D to −0.85D in mixed astigmatism (p < 0.001). In Amaris average cylinder decreased from −3.21D to −0.43D in myopic astigmatism (p < 0.001) and from −3.66D to −0.58D in mixed astigmatism (p < 0.001). Amaris group had less residual astigmatism (myopic astigmatism p = 0.023, mixed astigmatism p < 0.001). Mean spherical aberration shifted from positive to negative in mixed astigmatism for both lasers.

Conclusion

Both lasers are effective in terms of UDVA, CDVA, spherical correction, and preservation of high-order aberrations. However, Amaris was more effective in cylinder correction.