Clinical Ophthalmology (Feb 2024)
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
Anastasios John Kanellopoulos1,2 1Medical Director: The Laservision Clinical and Research Institute, Athens, Greece; 2Clinical Professor, Department of Ophthalmology, NYU Grossman Medical School, Department of Ophthalmology, New York City, NY, USACorrespondence: Anastasios John Kanellopoulos, Clinical Professor of Ophthalmology, NYU Medical School, Medical Director: The Laservision Clinical and Research Institute, 17 Tsocha Street, Athens, 115 21, Greece, Tel + 30 210 7472777, Fax + 30 210 7472789, Email [email protected]: 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.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
