Primary Topography-Guided LASIK: Refractive, Visual, and Subjective Quality of Vision Outcomes for Astigmatism ⩾2.00 Diopters

Wallerstein, Avi; Caron-Cantin, Marilou; Gauvin, Mathieu; Adiguzel, Eser; Cohen, Mark E.

doi:10.3928/1081597x-20181210-01

Cited by 24 publications

(22 citation statements)

References 20 publications

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“…LASIK was performed under topical anesthesia (Alcaine Drops, Alcon). All surgeons followed the same previously described standardized technique [3][4][5], using the same equipment and identical nomograms. Custom-Q® treatment software (F-CAT) was used on the WaveLight® Allegretto Wave® Eye-Q 400 Hz excimer laser.…”

Section: Surgical Techniquementioning

confidence: 99%

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Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from − 10.00 to − 13.50 diopters

Kam

Gauvin

Adiguzel³

et al. 2020

BMC Ophthalmol

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Background: To evaluate laser-assisted in situ keratomileusis (LASIK) outcomes, subjective quality of vision (QoV) and patient satisfaction in eyes with very high myopia (VHM) above − 10.00 diopters (D). Methods: Consecutive myopic and myopic-astigmatism eyes with spherical equivalent (SEQ) ranging between − 10.00 to − 13.50 D underwent LASIK with the WaveLight® Allegretto Wave® Eye-Q 400 Hz excimer laser. Treatment accuracy, efficacy, safety, stability, cylinder vectors, and higher-order aberrations were evaluated, together with subjective QoV and night vision disturbances (NVDs). Results: 114 eyes had a preoperative SEQ of − 11.02 ± 0.81 D, with a median follow-up of 24 months. A total of 72, 84, and 94% of eyes were within ± 0.50, ± 0.75 and ± 1.00 D of intended SEQ (R 2 = 0.71). The efficacy index was 0.93 ± 0.20, with 51 and 81% of eyes achieving 20/20 and 20/25. The astigmatism correction index was 0.95 ± 0.33. The safety index was 1.05 ± 0.12. The average myopic regression was − 0.51 ± 0.38 D. Preoperative QoV scores improved significantly postoperatively (7.5 ± 0.8 vs. 9.1 ± 0.7; P < 0.001), with less NVDs (P < 0.001). Total, spherical and coma root mean square (RMS) postoperative ocular higher-order aberrations were 1.07 ± 0.34, 0.67 ± 0.25, and 0.70 ± 0.40 μm. Conclusions: Very high myopia LASIK between − 10.00 to − 13.50 D is safe and results in good visual outcomes, with high patient satisfaction and a significant improvement in patient-reported QoV after surgery. Appropriately selected patients within this very high myopia group can be included as LASIK candidates.

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Section: Surgical Techniquementioning

confidence: 99%

“…Optical zone size was decreased in certain eyes below 6.5 mm to a minimum of 6.0 mm to save corneal tissue. Additional surgical technique details were published elsewhere [3][4][5]. A standardized postoperative regimen of antibiotics and steroids was used [6].…”

Section: Surgical Techniquementioning

confidence: 99%

Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from − 10.00 to − 13.50 diopters

Kam

Gauvin

Adiguzel³

et al. 2020

BMC Ophthalmol

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“…However, some studies are conservative in their selection of eyes, only selecting normal virgin eyes that have low preoperative ORA [ 2 , 15 , 16 ], others use normal virgin eyes with no ORA requirement [ 10 , 11 ], and some specifically choose to focus on eyes with high preoperative ORA. Some studies even include eyes with irregular astigmatism [ 3 , 17 ]. The substantially different populations of eyes make it very difficult to compare visual outcomes between studies.…”

Section: Introductionmentioning

confidence: 99%

Hemidivisional vector planning to reduce and regularize irregular astigmatism by laser treatment

Alpins

Ong²,

Stamatelatos

2022

Graefes Arch Clin Exp Ophthalmol

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Purpose To demonstrate how hemidivisional vector planning of refractive laser treatments of astigmatism can be used to directly address idiopathic corneal irregular astigmatism that has an asymmetrical, non-orthogonal bow tie topography appearance. Design Case study. Methods The cornea is conceptually divided into two hemidivisions along the flat meridian of the corneal topographic astigmatism (CorT), which means that each hemidivision will approximately correspond to one lobe of the asymmetric, non-orthogonal topographic bow tie. An astigmatism reduction treatment can then be planned separately for each hemidivision using the vector planning technique, based on both its two hemidivisional CorT measures and common manifest refractive cylinder. The remaining irregularity is then regularized, and the junctional zone smoothed across the flat meridian. The final intended treatment thus combines hemidivisional astigmatism reduction and regularization of the corneal astigmatism and spherical refractive error in one treatment application. This could be applied to LASIK, PRK, SMILE, and Transepithelial PRK procedures using Designer Cornea® software. Results A theoretical treatment profile is derived from an actual example of a cornea with idiopathic asymmetric non-orthogonal astigmatism. The three steps of the derivation are as follows: (i) astigmatism reduction through the use of the vector planning technique; (ii) regularization, and (iii) smoothing across the hemidivisional midline. Conclusions Hemidivisional vector planning treatments could potentially both reduce and regularize asymmetric non-orthogonal astigmatism. These treatments can be systematically customized to account for qualitative and quantitative differences between the two corneal hemidivisions at the same time as correction of coexistent myopia or hyperopia.

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“…Ocular astigmatism is one of the major factors affecting postoperative visual function after corneal refractive surgery 1 . With the increasing demand of the patients and surgeons for better postoperative visual quality, proper management of the ocular astigmatism has become increasingly important for corneal refractive surgery.…”

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A multicenter study of the distribution pattern of posterior corneal astigmatism in Chinese myopic patients having corneal refractive surgery

Zhu²,

Xiong³

et al. 2020

Sci Rep

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Including posterior corneal astigmatism (PCA) into consideration may increase the accuracy of astigmatism correction after corneal refractive surgery. In the present study we aim to investigate the distribution pattern of PCA in a large number of myopic patients from multiple ophthalmic centers. There were 7829 eyes retrospectively included in the study. Pentacam data of the eyes were retrieved from the machine and only results with image quality labelled with ‘OK’ were included. Distribution of PCA was slightly positively skewed (Skewness = 0.419, Kurtosis = 0.435, KS P < 0.0001). Mean PCA was 0.34 ± 0.14 D (range: 0.00 D-0.99 D). PCA was ≥ 0.25 D in 74.91% of the eyes and was ≥ 0.50 D in 11.61% of the eyes. In 97.55% of the eyes the steep meridian of PCA was vertical (SMV). PCA magnitude was significantly higher in eyes with SMV PCA (P < 0.0001) or high manifest astigmatism (MA, P < 0.0001). There was a significant correlation between anterior corneal astigmatism (ACA) magnitude and PCA magnitude in all of the eyes (r = 0.704, P < 0.0001). There was also a trend of decreasing frequency and magnitude of SMV PCA with aging (both P < 0.0001). In conclusion, PCA is present in myopic patients having corneal refractive surgery and PCA magnitude is increased with higher MA or ACA. Consideration of the impact of PCA on laser astigmatism correction may be necessary.

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Primary Topography-Guided LASIK: Refractive, Visual, and Subjective Quality of Vision Outcomes for Astigmatism ⩾2.00 Diopters

Cited by 24 publications

References 20 publications

Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from − 10.00 to − 13.50 diopters

Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from − 10.00 to − 13.50 diopters

Hemidivisional vector planning to reduce and regularize irregular astigmatism by laser treatment

A multicenter study of the distribution pattern of posterior corneal astigmatism in Chinese myopic patients having corneal refractive surgery

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