A Primary Clinical Observation Of Ray Tracing-Guided Fs-Lasik For Myopia And Astigmatism In Patients Aged Over 40 Versus Laser Blended Vision
Published 2026 - 44th Congress of the ESCRS
Reference: PP10.04 | Type: Free paper | DOI: 10.82333/kav4-he41
Authors: Prof. Fengju Zhang* 1 , Dr Jiayu Li 2 , Dr Wenjuan Wang 3 , Dr Yanzheng Song 2 , Dr Wenzai An 3 , Dr Jihong Zhou 3 , Dr Guoli He 3
1Department of Refractive Surgery,Beijing Aier-Intech Eye Hospital,Beijing,China;Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab,Beijing,China, 2Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab,Beijing,China, 3Department of Refractive Surgery,Beijing Aier-Intech Eye Hospital,Beijing,China
Purpose
To evaluate the early efficacy, safety, predictability, subjective and objective visual quality in patients aged over 40 undergoing ray tracing-guided femtosecond laser-assisted in situ keratomileusis (RG FS-LASIK) for myopia and astigmatism, and to compare with those receiving laser blended vision (LBV) surgery.
Setting
This prospective observational case series included 26 patients (52 eyes; 9 males, 17 females) with a mean age of 44.23±3.88 (40 to 53) years receiving RG FS-LASIK for myopia and astigmatism at Beijing Aier-Intech Eye Hospital between January 2025 and January 2026. Preoperative mean spherical equivalent (SE) and cylinder were –4.58±2.03D and –1.01±1.02D, respectively. For comparison, data from 26 patients matched by age, gender, and refraction who received LBV were retrospectively collected.
Methods
All patients underwent preoperative examinations, including repeated confirmation of the dominant eye and tolerance test. Postoperative assessments at 1 week, 1 month, and 3 months were analyzed. Monocular and binocular uncorrected distance and near visual acuity (UDVA and UNVA), corrected distance visual acuity (CDVA), and manifest refraction were measured. Defocus curves from –3.50 to +1.00D (0.50D increments) were obtained under photopic conditions. Whole-eye aberrations including primary spherical aberration (SA, Z40), root mean square of total higher-order aberrations, coma, and trefoil were measured using OPD-SCAN III (Nidek Inc, Tokyo, Japan) with a 6-mm pupil. Patients were inquired about satisfaction with visual outcomes.
Results
At 3 months after RG FS-LASIK, all patients achieved a binocular UDVA of 20/20, with 84% reaching 20/16, and 63% reached binocular UNVA of J1. None of the eyes lost lines of CDVA. Predictability was high (SE attempted vs achieved: R²=0.9896). Non-dominant-eye UNVA improved from 1 week to 3 months (P=0.012). 3-month defocus curve showed binocular vision better than 20/25 from –2.00 to 0.00D. All patients were satisfied with their visual performance. In comparison, both binocular UDVA >20/20 and UNVA J1 were achieved by 56.0% (RG FS-LASIK) and 54.3% (LBV); UNVA J4 was achieved by 100% in both groups. Primary SA and trefoil decreased after RG FS-LASIK, but increased after LBV, yet a statistical difference was only shown for trefoil (P=0.002).
Conclusions
This clinical attempt of RG FS-LASIK in patients aged over 40 demonstrated favorable efficacy, safety, and predictability compared to LBV. The enhanced distance and intermediate vision, along with a reduced primary SA indicated its advantages, particularly in patients with high myopia and astigmatism. In the future, long-term clinical observations can be conducted to verify its application value.