Comparison of outcomes of conventional WaveLight® Allegretto Wave® and Technolas® excimer lasers in myopic laser in situ keratomileusis

Abstract

ObjectiveTo compare the results of laser in situ keratomileusis for myopia using WaveLight® Allegretto Wave® Eye-Q® and Technolas® 217z excimer lasers.MethodA retrospective, comparative case series of 442 eyes matched for age and myopia: half each were treated with Allegretto’s wavefront-optimized algorithm and Technolas PlanoScan. Outcome measures were postoperative mean logarithm of the minimum angle of resolution (logMAR) uncorrected visual acuity (UCVA), manifest refraction spherical equivalent (MRSE), cylinder, safety and efficacy indices, refractive predictability, and optical zone size selection. Refractive predictability of a subgroup treated for −2.50 to −4.0 diopter (D) was analyzed separately.ResultsAt mean follow-up of 80.5 days, mean logMAR UCVA, mean MRSE and mean postoperative cylinder were 0.02 ± 0.07 (range −0.12 to 0.30), 0.27 ± 0.36 D (range −1.25 to 1.50 D) and −0.33 ± 0.30 D (range 0.00 to −1.50 D) for Allegretto versus 0.02 ± 0.08 (range −0.12 to 0.40), 0.095 ± 0.47 D (range −1.25 to 1.13 D) and −0.44 ± 0.5 2 D (range 0.00 to −2.25 D) for Technolas (P = 0.98, 0.80 and 0.006). Mean safety and efficacy indices were 1.05 ± 0.13 (0.75–1.33) and 0.97 ± 0.13 (0.50–1.33) for Allegretto and 1.07 ± 0.14 (0.75–1.49) and 0.97 ± 0.17 (0.40–1.49) for Technolas (P = 0.23 and 0.69). Proportions of eyes achieving postoperative MRSE within ±1.0 D, ±0.5 D, and ±0.25 D were 98.2%, 91.9% and 75.6% for Allegretto and 99.1%, 97.8% and 72.4% for Technolas (P = 0.68, 0.20 and 0.51). Mean optical zone size selected was 6.48 ± 0.10 mm (range 6.0–6.5 mm) for Allegretto and 6.38 ± 0.19 mm (range 5.6–6.6 mm) for Technolas (P < 0.001). Of the subgroup with treatment between −2.5 and −4.0 D, 86.8% and 58.5% of eyes treated with Allegretto achieved postoperative MRSE within ±0.50 D and ±0.25 D versus 70.4% and 44.4% for Technolas (P = 0.006 and 0.057).ConclusionNo differences were seen in postoperative mean logMAR UCVA, MRSE, safety and efficacy indices between the two lasers. Allegretto produced less residual astigmatism, possibly improved refractive predictability, and required smaller optical zone selection.

Long-term bladeless LASIK outcomes with the FS200 Femtosecond and EX500 Excimer Laser workstation: the Refractive Suite

“…The proportions of eyes achieving postoperative manifest refraction SE in the −0.50 to 0.00 D range was more than 87% at the 12-month visit (Figure 6); 95.7% were within ±1.0 D at the 1-year results. These results compare very favorably to other studies,21 in which for the same range of ±1.0 D, the proportions were in the range of 98%.…”

Refractive outcomes of an advanced aspherically optimized profile for myopia corrections by LASIK: a retrospective comparison with the standard aspherically optimized profile

“…The efficacy index per eye with the Triple-A profile is better than that reported in a comparison of the Wavelight ® Allegretto Wave ® and Technolas ® by Han et al17 and with the Schwind Amaris ® platform (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany) used by Alio et al19 The efficacy index per eye with the Triple-A profile (1.02–1.04) in our study is also slightly better than the efficacy index per eye calculated with data from the US Food and Drug Administration (FDA) clinical trial on the Carl Zeiss MEL 80 platform (0.99) 21…”

“…This value is lower than those reported by several studies 17,19–21. The UDVA results from different studies can be compared in terms of the efficacy index instead of a direct comparison of UDVA, as UDVA results are subject to individual differences introduced by physicians.…”

“…These indices are defined in two ways in literature. They can be described either as a ratio of the mean values of visual acuities16 or as the mean value of the ratio of visual acuities (per eye) 17. We decided to calculate both values: the “safety/efficacy index” (ratio of mean values) and the “safety/efficacy index per eye” (mean of ratios).…”

Topography-modified refraction (TMR): adjustment of treated cylinder amount and axis to the topography versus standard clinical refraction in myopic topography-guided LASIK

“…The platform offers the ability to import into the laser treatment planning mode the topographic data from the Placido-disk topographer (Vario, WaveLight) and topometry data from a Scheimpflug-based device (Oculyzer II-WaveLight), and accordingly customize the excimer treatment to the cornea (eg, for topography-guided treatment) 12. This study and previous studies have reported extensively the applications of topography-guided treatments with these platforms in irregular and normal eyes 22–29…”