Abstract
PurposeTo compare the visual and refractive outcomes after laser-assisted in situ keratomileusis (LASIK) surgery for correction of myopia or myopic astigmatism using a six-dimensional Amaris excimer laser.MethodsIn this retrospective cohort study, we enrolled 47 eyes of 28 patients (age: 19–36 years) with myopia or myopic astigmatism. We used the Custom Ablation Manager protocol and performed ablations with the SCHWIND AMARIS system. LASIK flaps were cut with an iFS Advanced Femtosecond Laser. Mean static (SCC) and dynamic cyclotorsion (DCC) were evaluated. Visual and refractive outcomes were evaluated during 6 months’ follow-up. Corneal asphericity (Q-value) was analyzed at 4 months postoperatively.ResultsThe spherical equivalent (SE) reduction was statistically significant reduce 1 day after refractive surgery (P < 0.001), with no additional significant changes during follow-up (P = 0.854). SCC registration rates were 81% in the Aberration-Free mode (AF) and 90% in the Corneal Wavefront mode (CW). SCC measurements were within ± 5 degrees in 57% (AF) and 68% (CW) of eyes. Mean DCC was within ± 1 degree in 96% (AF) or 95% (CW) of cases. At 6 months, the uncorrected distance visual acuity was 20/25 or better in all eyes. At last follow-up, both steep and flat keratometry values had significantly flattened in both groups (P < 0.001). Corneal asphericity also increased significantly during the postoperative period for an 8-mm corneal diameter (P < 0.001).ConclusionsLASIK for myopia or myopic compound astigmatism correction using the six-dimensional AMARIS 750S excimer laser is safe, effective, and predictable. Postoperative corneal asphericity can be analyzed by linear regression to predict the changes in postoperative corneal asphericity with this approach.
Highlights
Given the increase in the number of myopic patients in the population, refractive surgery is the most commonly used surgical technique for correction of myopia or myopic astigmatism
static cyclotorsion (SCC) measurements were within ± 5 degrees in 57% (AF) and 68% (CW) of eyes
Mean dynamic cyclotorsion (DCC) was within ± 1 degree in 96% (AF) or 95% (CW) of cases
Summary
Given the increase in the number of myopic patients in the population, refractive surgery is the most commonly used surgical technique for correction of myopia or myopic astigmatism. Photorefractive keratectomy (PRK), laser in situ keratomileusis (LASIK), and laser epithelial keratomileusis (LASEK) are the most frequently used refractive surgery methods. Myopic-correction refractive surgery induces an increase in higher-order aberrations (HOAs), especially spherical aberrations, [1] which can degrade the visual quality with halos, glare, starbursts and night vision. Better control of flap creation with larger and more accurate femtosecond laser flaps may enhance performing myopia or myopic-compound astigmatism correction refractive surgery with a larger ablation zone (AZ) and may achieve more positive postoperative visual outcomes
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