Abstract
Background:Laser-Assisted in situ Keratomileusis (LASIK) can induce corneal aberrations that can impact vision and patient satisfaction. Recent developments in laser technologies have helped minimise these aberrations.Objective:To assess the quality of vision and change in Higher-Order Aberrations (HOAs) following wavefront-optimized LASIK in low-myopic astigmatic patients.Methods:LASIK was performed on a total of 76 eyes in patients with myopia <4.0 D and cylinder <2.0 D using the WaveLight® EX500 excimer and FS200 femtosecond laser platform. Visual acuity, contrast sensitivity and HOAs were measured at 1 and 3 months postoperatively and compared to preoperative values. Subjective quality of vision was assessed pre- and postoperatively using a VF14 questionnaire.Results:Mean postoperative Spherical Equivalent (SE) was -0.09 ± 0.26 µm with 95% of patients within ± 0.5 D of attempted SE. Postoperative uncorrected distance visual acuity was 20/20 or better for 96% of patients. Contrast sensitivity increased against horizontal and vertical gratings at all spatial frequencies except for vertical gratings at 18 cycles/degree. Spherical aberration and total HOA increased by 0.085 µm and 0.13 µm respectively. The mean VF14 score increased from 89.2 ± 16.7% to 99 ± 1.4% postoperatively.Conclusion:LASIK performed using the WaveLight® EX500 excimer and WaveLight® FS200 laser platform provided improved contrast sensitivity and visual acuity with minimal introduction of HOAs, making it a suitable platform for low myopic astigmatic patients.
Highlights
Since its first reported use on human eyes by Pallikaris et al [1], Laser-Assisted in situ Keratomileusis (LASIK) has become the most common refractive1874-3641/18 2018 Bentham OpenOutcomes and Higher Order LASIK on EyesThe Open Ophthalmology Journal, 2018, Volume 12 85 procedure to correct ametropia
Spherical aberration and total Higher-Order Aberrations (HOA) increased by 0.085 μm and 0.13 μm respectively
This study aims to assess the outcome of LASIK utilising the WaveLight® EX500 excimer and FS200 femtosecond laser platform, in order to determine the viability of this platform for use on patients with low myopia and astigmatism
Summary
Since its first reported use on human eyes by Pallikaris et al [1], LASIK has become the most common refractive1874-3641/18 2018 Bentham OpenOutcomes and Higher Order LASIK on EyesThe Open Ophthalmology Journal, 2018, Volume 12 85 procedure to correct ametropia. Surgeons generally report high levels of patient satisfaction following LASIK, and this generally is dependent on factors such as good postoperative Unassisted Distance Visual Acuity (UDVA). Some issues that affect patient satisfaction have been identified including residual ametropia and Higher-Order Aberrations (HOA). Pre-existing HOAs can be exacerbated by LASIK as a result of the ablation process itself as well as multiple other factors including corneal dehydration [2] and decentration [3 - 5]. Visual distortion results from the induction of an oblate corneal shape. This is problematic following the use of conventional ablation profiles, which are calculated based on the sphere, cylinder and pupil size of the eye. Recent developments in laser technologies have helped minimise these aberrations
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