Ray-Tracing Customization in Myopic and Myopic Astigmatism LASIK Treatments for Low and High Order Aberrations Treatment: 2-Year Visual Function and Psychometric Value Outcomes of a Consecutive Case Series

Abstract

Purpose

The safety and long-term efficacy of automated ray-tracing customized myopic and myopic astigmatic femtosecond laser-assisted LASIK.

Methods

This consecutive case series retrospective analysis, of 20 subjects (40 eyes) treated with automated raytracing named Wavelight Plus, to include low and high order aberrations based on a three-dimensional custom virtual eye for each case-calculated from interferometry data-obtained from a single diagnostic device that also provides Hartman–Shack Wavefront and Scheimpflug tomography data. We evaluated before and after the customized LASIK procedure: visual acuity, refractive error, high order aberrations, contrast sensitivity, and psychometric post-operative visual function data.

Results

At 24 months, the comparison of the pre-operative to the post-operative refractive and visual function value changes in average were: subjective manifest refraction from −4.38 ± 2.54 diopters (D) (range −9.75 to −1.25 D) to +0.11 ± 0.19 D; subjective manifest refractive astigmatism from −0.76 ± 0.91 D (range −2.75 to 0 D) to −0.13 ± 0.16 D, corneal astigmatism from −1.16 ± 0.64 D (range −0.2 to −2.8) to −0.47 ± 0.11 D. 65% of the eyes studied demonstrated an increase of at least one line of vision, while from the same group 38% demonstrated 2 lines of increase. High order aberrations, contrast sensitivity as well as the subjective psychometric input based on the VFQ-25 questionnaire demonstrated actual improvement.

Conclusion

This longer-term follow-up, single-arm retrospective consecutive case series documents LASIK treatment customization that appears to be safe and effective in the correction of myopia and myopic astigmatism. Markedly improved objective and subjective visual function post-operatively, underlying the potential importance of simultaneously attempting to correct high order aberrations and improving the spatial alignment of total, measured human eye optics.

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© 2024 Kanellopoulos et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Keywords:

• raytracing excimer customization of myopic corrections
• topography-guided
• wavefront-guided
• femtosecond-laser assisted myopic LASIK
• customized excimer laser ablation: human eye optical tilt between the cornea and the crystalline lens

Credits

The VFQ-25 questionnaire used in this study was developed at RAND under the sponsorship of the National Eye Institute.

Study Data Sharing

The authors have posted individual deidentified participant data to be asseccible on the registry link below. The specific data are noted on a spreadheet and include patient sex, age, preoperative refraction, keratometry, UDVA and CDVA, as well as the 1 month 3 month and 24 month data. They will be accessible indefinitely as noted in the statement below: All individual deidentified participant data will be available at the ISRCTN registry as: ISRCTN73528436. Registry access link: https://doi.org/10.1186/ISRCTN73528436.

Disclosure

The author (AJK) serves among other commercial entities as a scientific consultant for Alcon/Wavelight (Erlangen, Germany).

Additional information

Funding

This study # 59917561, was funded by a non-restricted investigator-initiated study, by Alcon Hellas. Presented in part as a poster at the winter ESCRS meeting in Portugal, February 2022 and the ASCRS meeting in Washington, DC April 2022.