LASIK for Myopia With Aspheric “Aberration Neutral” Ablations Using the ESIRIS Laser System

Abstract

To evaluate the clinical outcomes of LASIK using optimized "aberration neutral" ablation profiles. Laser in situ keratomileusis was performed in 231 eyes (120 patients) with a mean spherical equivalent refraction of -4.12+/-2.26 diopters (D) (range: -0.37 to -9.50 D) using a SCHWIND Pendular microkeratome with a 130-microm cutting head and the SCHWIND ESIRIS excimer laser. In all cases, pre- and postoperative autorefractor measurements, manifest refraction, best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), topography and corneal wavefront analysis, and ocular wavefront analysis as well as complications were analyzed. Ablations were calculated using the ORK-CAM software. Clinical outcomes were evaluated in terms of efficacy, predictability, stability, refractive outcome, safety, and wavefront aberrations. At 3 months, mean spherical equivalent refraction was -0.10+/-0.33 D (range: +0.86 to -1.18 D). Of 231 eyes, 201 (87%) were within +/-0.50 D of attempted correction. Uncorrected visual acuity was 20/16 or better in 71% (164 eyes), 20/20 or better in 92% (213 eyes), and 20/32 or better in 100%. Average root-mean-square higher order aberrations increased 0.05 microm after treatment, mean spherical aberration increased 0.08 microm after treatment, and mean coma increased 0.04 microm after treatment (all for 6.0-mm analysis diameter). Our results show that non-customized "aberration neutral" ablation profiles derived from wavefront analysis are able to minimize the amount of induced aberrations of both the cornea and the eye.