Clinical Outcomes of Aberration-Free All Surface Laser Ablation (ASLA) vs. Aberration-Free ASLA Assisted by Smart Pulse Technology in High Myopia: A One-Year Follow-Up Study.

Xiaohao Du,Qinmei Wang,Wenjia Cao,Meng Su,Shihao Chen,Jia Zhang,Ioannis M Aslanides,Shuang Zeng,Zisis Gatzioufas

doi:10.1155/2021/2588765

Abstract

Purpose To compare the clinical outcomes of aberration-free all surface laser ablation (ASLA) with and without the use of smart pulse technology (SPT) in high myopia. Methods This study retrospectively analyzed 138 eyes (138 patients, only the right eye was selected) treated for high myopia (spherical equivalent ≥−6.00 diopters) using aberration-free ASLA (non-SPT group; 85 eyes) and aberration-free ASLA assisted by SPT (SPT group; 53 eyes). Examinations such as visual acuity, refraction, and haze were performed before the 12-month follow-up. Corneal epithelial healing time was assessed in the first postoperative day. Visual acuity and refraction examination were performed at 7 days and 1, 3, 6, and 12 months postoperatively. Corneal haze was evaluated in 1, 3, 6, and 12 months. Safety, efficacy, and corneal wavefront aberrations were assessed 12 months after the treatment. Results At 12 months postoperatively, 60% versus 40% of eyes achieved 20/16 Snellen lines or better, and 92% versus 82% of eyes achieved 20/20 Snellen lines or better visual acuity in the SPT and the non-SPT groups, respectively. The average postoperative epithelial healing time was 3.75 ± 1.00 days in the SPT group and 3.73 ± 1.30 days in the non-SPT group (P ≥ 0.05). The safety and the efficacy index of the SPT group were better than those of the non-SPT group in the follow-ups. The attempted spherical equivalent before the surgery and the achieved spherical equivalent at 12 months were comparable between the two groups. Regarding the aberrations, the results of Coma 90° in the SPT group were better than those in the non-SPT group (P ≤ 0.05), but the increase of RMS HOAs (root mean square higher order aberrations), Coma 0°, and spherical aberration postoperatively had no statistical difference between the two groups (P ≥ 0.05). Conclusions: Both aberration-free ASLA with and without SPT showed favorable safety, effectiveness, and predictability within 12 months for high myopia. And, ASLA using SPT might have potential advantages in the long-term visual quality.

Highlights

To compare the clinical outcomes of aberration-free all surface laser ablation (ASLA) with and without the use of smart pulse technology (SPT) in high myopia
Amaris platform (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany) termed transepithelial all surface laser ablation (ASLA) and replaced the original method of TransPRK based on a grid-like corneal representation mode by software update. e advantages of SPT-assisted ASLA (SPT-ASLA) such as early postoperative vision recovery, pain and epithelial healing, corneal asphericity, and reduction of the irregularity of the stromal surface have been reported in some studies [6, 9, 10]. e results of the available research indicate that SPT-ASLA might optimize the geometric arrangement of pulses during laser ablation to make the corneal bed smoother, leading to earlier postoperative visual recovery, faster corneal re-epithelialization, and less haze occurrence than surface ablation without the SPT
At 12 months after the treatment, the change of uncorrected distance visual acuity (UDVA), sphere, cylinder, and spherical equivalent has no statistical difference between two groups. e improvement of corrected distance visual acuity (CDVA) in SPT group seems statistically better than that in the non-SPT group (Table 2)

Summary

Introduction

To compare the clinical outcomes of aberration-free all surface laser ablation (ASLA) with and without the use of smart pulse technology (SPT) in high myopia. Is study retrospectively analyzed 138 eyes (138 patients, only the right eye was selected) treated for high myopia (spherical equivalent ≥−6.00 diopters) using aberration-free ASLA (non-SPTgroup; 85 eyes) and aberration-free ASLA assisted by SPT (SPT group; 53 eyes) Examinations such as visual acuity, refraction, and haze were performed before the 12-month follow-up. E results of the available research indicate that SPT-ASLA might optimize the geometric arrangement of pulses during laser ablation to make the corneal bed smoother, leading to earlier postoperative visual recovery, faster corneal re-epithelialization, and less haze occurrence than surface ablation without the SPT. E aim of this study was to comparatively evaluate the long-term clinical outcomes of aberration-free SPT-ASLA versus non-SPT-ASLA in patients with high myopia

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