Retrospective Analysis Of Wavefront-Optimized Myopic Lasik: Comparison Of Preoperative To Postoperative Astigmatism And High Order Aberrations: Trefoil And Coma Specifically. Could Topography-Guided Original Customization, Had Addressed The Above?
Published 2024 - 42nd Congress of the ESCRS
Reference: PP15.01 | Type: Free paper | DOI: 10.82333/njzv-vn74
Authors: Anastasios John Kanellopoulos* 1 , Alexandros John Kanellopoulos 2
1Ophthalmology,LaserVision Ambulatory Eye Surgery Unit,Athens,Greece;Ophthalmology,NYU Med School,New York,United States, 2Ophthalmology,LaserVision Ambulatory Eye Surgery Unit,Athens,Greece
Purpose
The purpose of this retrospective study was to evaluate and analyze visual outcomes by recording pre and postoperative trefoil, coma and refractive astigmatism in wavefront optimized myopic LASIK.
Setting
The Laservision Clinical and Research Institute, Athens, Greece
Methods
In this retrospectivecase review 200 eyes (one hundred patients) that had undergone myopic (with corresponding astigmatism) wavefront-optimized LASIK using the FS200 femtosecond and EX500 excimer lasers (Alcon/Wavelight, Erlagen, Germany) were evaluated. The 12 months post-operative UDVA and CDVA, low (myopia and/or astigmatism) along with high order aberration C6 to C9 changes were compared to the pre-operative values. Pre-operative topography data were available and used to generate for this study hypothetical treatment data (low and high order aberrations) if topography-guided (TG) with TMR cylinder amount and axis adjustment was used instead of the actual WFO.
Results
Mean values at 12 months: UDVA of 20/22 and CDVA of 20/20. The postoperative refractive error in Diopters was -0.20 ± 0.46 sphere and - 0.45 ± 0.27 cylinder. The average absolute value for the high order aberrations studied were pre-op: C6: 0.10 ± 0.12, C7: 0.19 ± 0.16, C8: 0.15 ± 0.12, C9: 0.09 ± 0.09 μm and respectively post-op, C6: 0.11 ± 0.10, C7: 0.46 ± 0.38, C8: 0.34 ± 0.30, C9: 0.11 ± 0.13 μm. If topography-guided customization with TMR was originally employed an addition mean -0.36D of astigmatism would have been attempted
Conclusions
Wavefront optimized ablations do not address HOA, pre-existing trefoil (C6, C9) in this group essentially did not change while coma (C7 and C8) increased despite the essential achievement of emmetropia . In theory topography-guided customization with TMR may had offered improved C7 and -C8 outcomes, along with superior cylindrical correction.