Comparative analysis of visual outcomes and ocular aberrations following wavefront optimized and topography-guided customized femtosecond laser in situ keratomileusis for myopia and myopic astigmatism: A contralateral eye study

Tiwari, Nitin Narendra; Sachdev, Gitansha Shreyas; Ramamurthy, Shreyas; Dandapani, Ramamurthy

doi:10.4103/ijo.ijo_507_18

Cited by 27 publications

(4 citation statements)

References 11 publications

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“…These findings suggest that visual acuity outcomes cannot be attributed solely to the ablation profile and that both profiles demonstrate similar efficacy and safety. The results of the present study are consistent with those of other studies comparing different ablation profiles in LASIK [13][14][15][16].…”

Section: Discussionsupporting

confidence: 93%

Comparison of Outcomes after Wavefront-optimized and Topography-guided Transepithelial Photorefractive Keratectomy

Kim,

Na,

Choi

et al. 2024

Korean J Ophthalmol

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Purpose: To evaluate the outcomes of wavefront-optimized (WFO) and topography-guided (TG) transepithelial photorefractive keratectomy (transPRK) in the treatment of myopia and myopic astigmatism.Methods: Patients who underwent transPRK using the WaveLight EX500 excimer laser for the correction of myopia and myopic astigmatism between January 2022 and March 2023 were divided into groups of WFO transPRK (77 eyes of 36 patients) or TG transPRK (63 eyes of 31 patients) in this retrospective, observational cohort study. The preoperative and postoperative 3-month refractive and visual outcomes of the two groups were analyzed.Results: In both groups, the uncorrected distance visual acuity was 0.0 logarithm of the minimum angle of resolution or better in 95% of eyes 3 months postoperatively, and the mean manifest refraction spherical equivalent was within ±1.0 diopter in 90% of eyes. No significant differences were observed between the groups in terms of the uncorrected distance visual acuity or astigmatism. A significant induction of higher order aberrations (HOAs) was observed in both groups. However, the induction of total corneal HOAs (p = 0.014) and spherical aberrations (p < 0.001) was significantly lower in the TG group than that in the WFO group.Conclusions: WFO and TG transPRK effectively improved the visual and refractive outcomes; however, the induction of total corneal HOAs and spherical aberration was lesser following the TG ablation.

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Section: Discussionsupporting

confidence: 93%

Comparison of Outcomes after Wavefront-optimized and Topography-guided Transepithelial Photorefractive Keratectomy

Kim,

Na,

Choi

et al. 2024

Korean J Ophthalmol

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“…Although some recent studies have achieved results similar to those obtained in the FDA trial, 30,31 some of the authors of this report (MCL, TPL), as well as several other investigators, [32][33][34] have been unable to obtain the excellent postoperative visual acuities obtained during the FDA trial when the same treatment protocol was applied to eyes encountered in routine clinical practice. Various alternative strategies have been proposed, therefore, to determine the appropriate laser entry for the Treatment sphero-cylindrical refraction.…”

Section: Discussionmentioning

confidence: 51%

Topography-Guided Refractive Astigmatism Outcomes: Predictions Comparing Three Different Programming Methods

Stulting

Durrie

Potvin³

et al. 2020

OPTH

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Purpose: To identify the laser programming strategy that will achieve optimal refractive outcomes of LASIK with a topography-guided laser for eyes with a disparity between cylinder measured by manifest refraction and cylinder measured by topography. Setting: Six surgeons at 5 clinical sites in the USA. Design: Retrospective data review. Methods: Preoperative, treatment, and postoperative data on 52 eyes that underwent topographyguided LASIK with the WaveLight EX500 Contoura ® Vision excimer laser ablation profile in which the vectors representing the preoperative refractive cylinder and the cylinder measured by the WaveLight ® Topolyzer™ VARIO Diagnostic Device (Vario cylinder) differed by >/= 0.50D and/or >/= 10 degrees of orientation were analyzed retrospectively. Data were contributed by six surgeons using the laser at 5 different clinical sites. Vector analysis of postoperative cylindrical refractive error and the actual laser programming strategy was used to calculate the cylindrical correction that would, theoretically, have completely eliminated postoperative refractive cylinder. This was compared to expected results using the preoperative manifest cylinder, the topographic cylinder, and the Phorcides Analytic Engine (Phorcides LLC, North Oaks MN; Phorcides). For analysis, subjects were stratified on the basis of the vector difference between Manifest and Topo cylinder (High, >0.75 D; and Low, ≤0.75 D). Results: The poorest calculated theoretical outcomes were obtained with the manifest refraction (centroid: −0.43, 0.22; mean calculated error vector: 0.56 ± 0.42 D; p=ns). Better outcomes were obtained with the topographically measured refraction (centroid: 0.37, 0.02; mean calculated error vector: 0.47 ± 0.33 D; p=ns). The best outcomes were obtained with Phorcides (centroid: −0.15, 0.06; mean calculated error vector: 0.39 ± 0.28 D; p=ns). The mean error vector magnitude in the Phorcides Low group was significantly lower than for the Manifest and Topo Low groups (0.26 D vs 0.48 D and 0.33 D; p<0.01). The mean error magnitude in the Phorcides High group was nearly 0.25 D lower than for the Manifest High group (0.48 D vs 0.70 D; p<0.01), but was the same as for the Topo High group (0.48 D vs 0.48 D). Conclusion: Our study suggests that using the topographically measured cylinder or the cylinder selected by Phorcides will produce more desirable refractive outcomes than entry of the preoperative refractive cylinder as the basis for correction of myopia and myopic astigmatism with the WaveLight Contoura Vision excimer laser.

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“…16 Some studies reported better visual outcomes with the customized laser platforms rather than with the standard and optimized correction, 15,17 owing to the ability of the customized ablation to reduce the corneal HOAs and thereby improve the visual performance. By contrast, other studies 18,19 failed to demonstrate a significant, clinically relevant, benefit of customized corneal ablation techniques over the traditional optimized procedures with cyclotorsion control. Some investigators consider customized corneal ablation as beneficial but only if substantial corneal HOAs exist, which was given an average magnitude of 0.30-0.35 um, regardless of the amount of corneal astigmatism.…”

Section: Discussionmentioning

confidence: 88%

Relation of Corneal Astigmatism with Various Corneal Image Quality Parameters in a Large Cohort of Naïve Corneas

Yousif

Elkitkat

Alaarag

et al. 2020

OPTH

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Purpose: To investigate the relationship between corneal astigmatism and corneal image quality parameters (i.e., root mean square [RMS] of some major corneal higher order aberrations [HOAs] "namely RMS of coma aberrations, RMS of trefoil aberrations, and RMS of spherical aberration [RMS-SA]" and Strehl ratio [SR] of point spread function [PSF]) by using the Sirius topographer (CSO Italia, Florence, Italy). Patients and Methods: This cross-sectional study used the Sirius topographer to evaluate the naïve corneas of right eyes (n = 1,356). The study included three groups which were based on the mean anterior corneal astigmatism value (group 1, <1 D; group 2, 1-2 D; and group 3, >2 D). Results: The corneal astigmatism showed statistically significant (yet narrow clinical) differences among the groups regarding all the examined parameters (P<0.001), except for the RMS-SA (which was statistically insignificant among the three groups). Correlation coefficients were weak between the corneal astigmatism and HOAs (correlation coefficient "r" not reaching 0.2 with any of the evaluated HOAs). Conclusion: Significant differences existed among the astigmatic groups regarding corneal HOAs, but the mean values were very close. The deduced relations between corneal astigmatism and corneal image quality parameters had limited clinical relevance. Thus, the corneal astigmatism should be evaluated separately from corneal image quality parameters, either when deciding between refractive correction modalities (customized versus optimized ablation techniques) or when evaluating corneal image quality of a naïve cornea.

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Comparative analysis of visual outcomes and ocular aberrations following wavefront optimized and topography-guided customized femtosecond laser in situ keratomileusis for myopia and myopic astigmatism: A contralateral eye study

Cited by 27 publications

References 11 publications

Comparison of Outcomes after Wavefront-optimized and Topography-guided Transepithelial Photorefractive Keratectomy

Comparison of Outcomes after Wavefront-optimized and Topography-guided Transepithelial Photorefractive Keratectomy

<p>Topography-Guided Refractive Astigmatism Outcomes: Predictions Comparing Three Different Programming Methods</p>

<p>Relation of Corneal Astigmatism with Various Corneal Image Quality Parameters in a Large Cohort of Naïve Corneas</p>

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