Abstract

-Purpose: To evaluate early visual, refractive and aberrometric outcomes after wave front-guided LASIK for the correction of low to moderate myopia and myopic astigmat is musing the excimer laser platform Advanced Custom Vue. Methods: A prospective, non-comparative study in 100 myopic eyes of 50 patients evaluating LASIK results over a period of 3 months. Main outcome variables included visual acuity, refraction, total higher-order aberrations (HOAs), spherical aberration (SA) and coma-like aberration. The surgery was performed using the VISX STAR S4 (Johnson and Johnson Vision) excimer laser and a wave front-guided ablation designed according to the iDesign aberrometer data (Johnson and Johnson Vision). Results: Mean preoperative sphere decreased from -4.07 ± 1.78 D to 0.32 ± 0.30 D at 3 months after surgery. Mean preoperative cylinder was reduced from -1.09 ± 0.88 D to -0.26 ± 0.28 D after the complete follow-up. Postoperative uncorrected distance visual acuity (UDVA) was 0.00 logMAR (20/20) or better in 100% of eyes, and 65.3% of eyes reached an UDVA of -0.20 logMAR (20/12.5) or better (p < 0.05). For a 6-mm pupil, the root mean square (RMS) for total ocular HOAs increased with surgery by 0.03 μm (p = 0.050), whereas the coma-like RMS increased by 0.05 μm (p < 0.001). The change in spherical aberration was +0.08 μm (p < 0.001). Conclusion: Wavefront-guided LASIK using the new generation excimer laser platform Advanced Custom Vue is safe and effective for treating myopia and myopic astigmatism, minimizing the postoperative level of HOAs.

Highlights

  • For a 6-mm pupil, the root mean square (RMS) for total ocular higher-order aberrations (HOA) increased with surgery by 0.03 μm (p = 0.050), whereas the coma-like RMS increased by 0.05 μm (p < 0.001)

  • It has been demonstrated that Laser in situ keratomileusis (LASIK) procedure is effective and predictable for correcting myopic refractive errors, the induction of higher order aberrations (HOAs) due to changes of the corneal shape is a major concern for practitioners [1]

  • Mean logMAR uncorrected distance visual acuity (UDVA) improved from 1.05 ± 0.48 (SD) preoperatively to −0.04 ± 0.06 (SD) at one month and −0.06 ± 0.06 (SD) at 3 months postoperative

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Summary

Introduction

It has been demonstrated that Laser in situ keratomileusis (LASIK) procedure is effective and predictable for correcting myopic refractive errors, the induction of higher order aberrations (HOAs) due to changes of the corneal shape is a major concern for practitioners [1]. In order to improve the postoperative outcomes different algorithms have been developed, and aspheric profiles have been fully incorporated to the different laser platforms to minimize those undesirable optical side effects. The Customvue platform using the iDesign high resolution aberrometer (Advanced CustomVue, Johnson and Johnson Vision) incorporates a wavefront-guided (WF-guided) profile based on the preoperative aberrometry data and on the values of the root mean square (RMS) [4]. This prospective study aims to evaluate the visual outcomes and changes in HOAs after LASIK using the Advanced CustomVue excimer laser platform

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