Clinical Ophthalmology (Aug 2018)
The use of WaveLight Contoura to create a uniform cornea: 6-month results with subjective patient surveys
Abstract
Manoj Motwani,1 Ronald Pei2 1LASIK Institute, San Diego, CA, USA; 2Precision Outcome Consultants, Fresno, CA, USA Purpose: The aim of this study was to report on the 6-month visual results of Contoura with Layer Yolked Reduction of Astigmatism (LYRA) protocol, as well as the subjective patient-reported outcomes (PRO) by standardized survey. Patients and methods: A retrospective analysis was conducted in 50 consecutive eyes with 6-month results that had bilateral Contoura laser-assisted in situ keratomileusis (LASIK) correction of measured astigmatism and axis using the LYRA protocol. PRO were measured via the Refractive Status and Vision Profile (RSVP) standardized survey. Objective visual results, subjective patient results, and rates of regression were reported. Results: Most (78%) of the eyes achieved an uncorrected visual acuity (UCVA) of 20/15 and 98% of the eyes achieved an UCVA of 20/20 vision after primary correction. After enhancements, the percentage of uncorrected eyes achieving 20/15 vision was 90 and 20/20 vision was 100. RSVP patient-related outcomes showed that all patients (100%) were either satisfied or very satisfied with their vision. Most patients (21/25, 84%) were very satisfied. On a numerical ordinal scale of 1–10 (where 10 is the best vision), as reported by patients post-operative (post-op), 15 (60%) patients reported a vision score of 10, nine (36%) patients reported a score of 9, and one (4%) patient reported a score of 8. Initial correction was accurate on all patients, but nine eyes had refractive error changes due to epithelial masking of higher order aberrations (HOAs) over the follow-up period, a number that was also likely artificially high due to study bias. Conclusion: Contoura measured axis and astigmatism-eliminated HOA, resulting in a more uniform cornea with an accurate removal of astigmatism, excellent 20/15 and 20/20 visual outcomes, and favorable patient-reported subjective outcomes. Keywords: astigmatism, WaveLight Contoura, topography-guided ablation, LASIK, cornea, Contoura with LYRA protocol
