Ray-Tracing-Guided Lasik For Moderate-To-High Myopia: Clinical And Patient-Reported Outcomes

To evaluate the outcomes of ray-tracing-guided laser-assisted in situ keratomileusis (LASIK) for moderate-to-high myopia with astigmatism, focusing on objective visual quality and subjective patient satisfaction.

This study was conducted at the Department of Ophthalmology in the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China

A total of 84 patients (165 eyes) with a spherical equivalent (SE) of -3.00 diopters (D) or higher were included. All patients underwent ray-tracing-guided LASIK, which involved creating an individualized 3D eye model based on InnovEyes Sightmap-meaured wavefront, tomography, and biometry data to calculate a customized ablation profile . Evaluations at 3 months postoperatively included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, higher-order aberrations (HOAs), Optical Quality Analysis System (OQAS) parameters, and the National Eye Institute Refractive Error Quality of Life (NEI-RQL) questionnaire. Patient feedback and satisfaction were also recorded.

At the 3-month follow-up, 100% of the treated eyes achieved an UDVA of 20/20 or better. The mean refractive spherical equivalent (MRSE) was 0.15 ± 0.20 D, with 96% of eyes within ±0.50 D of the target refraction . While total HOAs showed a slight, statistically significant increase (0.09 ± 0.14 μm, p < 0.001), spherical aberration remained unchanged (p = 0.225). OQAS parameters, including the MTF cutoff, Strehl ratio, and ocular scatter index, demonstrated no significant changes, indicating stable optical quality . Subjectively, 98.7% of patients reported satisfaction with the outcomes, 94.8% stated they would recommend the surgery, and high rates of clear vision at various distances were recorded via the NEI-RQL questionnaire.

Ray-tracing-guided LASIK is safe, effective, and predictable for correcting moderate-to-high myopia with astigmatism. The personalized ablation profile, based on whole-eye wavefront modeling, effectively controlled the induction of spherical aberration and maintained stable visual quality. Despite the observation of mild overcorrection and vertical coma changes, the objective visual quality metrics remained satisfactory, and patients reported high levels of subjective visual quality and overall satisfaction with the procedure.