WaveLight Allegretto Wave Eye-Q Research Articles

Quality of life and satisfaction among physicians after wavefront-optimized vs topography-guided laser vision correction.

To assess satisfaction, quality of life, occupational impact, and clinical outcomes of physicians who have undergone laser vision correction (LVC) using either wavefront-optimized (WFO) or topography-guided (TG) excimer laser ablation profile with femtosecond laser flap creation. Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA. Retrospective survey study. A 12-question survey was sent to all physicians who underwent laser in situ keratomileusis or photorefractive keratectomy at the Cole Eye Institute between 2011 and 2018 on the WaveLight Allegretto Wave Eye-Q Laser (Alcon Laboratories, Inc.). Visual outcomes were obtained from patient charts. Two hundred thirty-five physicians (454 eyes) met the study's inclusion criteria, including 181 physicians (353 eyes) who underwent WFO LVC and 54 physicians (101 eyes) who underwent TG LVC. One hundred seventeen physicians (49.8%) responded to the survey and reported an overall satisfaction rate of 98.3% among all physicians receiving LVC with 96.6% reporting they would have the procedure again. Visual outcomes showed a high level of surgical predictability, efficacy, and safety among WFO and TG eyes, with a higher percentage of eyes that received TG ablation achieving 20/10 vision (22% vs 4%, P < .0001) and 20/15 vision (87% vs 69%, P < .01) when compared with WFO eyes. Physicians who had undergone LVC with either WFO or TG excimer laser ablation reported high satisfaction and quality-of-life improvements. Both groups achieved excellent visual outcomes, with a higher percentage of TG eyes achieving 20/10 and 20/15 vision.

A sample predictive model for intraocular pressure following laser in situ keratomileusis for myopia and an "intraocular pressure constant".

To describe a sample predictive model for intraocular pressure (IOP) following laser in situ keratomileusis (LASIK) for myopia and an IOP constant. The records of patients that underwent LASIK for myopia and myopic astigmatism via WaveLight Allegretto Wave Eye-Q 400Hz excimer laser and Hansatome XP microkeratome were retrospectively reviewed. Patients with no systemic or ocular disease other than myopia or myopic astigmatism were included in the study. Preoperative and postoperative month 1 data and intraoperative data were used to build the predictive model for IOP after LASIK. The IOP constant was calculated by subtracting the predicted IOP from preoperative IOP. The paired samples t test, Pearson's correlation analysis, curve estimation analysis, and linear regression analysis were used to evaluate the study data. The study included 425 eyes in 214 patients with a mean age of 32±7.8years. Mean spherical equivalent of the attempted correction (SE-ac) was -3.7±1.7diopters. Mean post-LASIK decrease in IOP was 4.6±2.3mmHg. The difference between preoperative and postoperative IOP was statistically significant (P<0.001). SE-ac, preoperative IOP, and central corneal thickness had highly significant effects on postoperative IOP, based on linear regression analysis (P<0.001 and R 2=0.043, P<0.001 and R 2=0.370, and P<0.001 and R 2=0.132, respectively). Regression model was created (F=127.733, P<0.001), and the adjusted R 2 value was 0.548. Evaluation of IOP after LASIK is important in myopic patients. The present study described a practical formula for predicting the true IOP with the aid of an IOP constant value in myopic eyes following LASIK.

Subjective Quality of Vision After Myopic LASIK: Prospective 1-Year Comparison of Two Wavefront-Guided Excimer Lasers

To compare subjective quality of vision between two wavefront-guided lasers in the treatment of myopia up to 1 year postoperatively. In this prospective randomized study, 100 eyes of 50 patients were treated with wavefront-guided LASIK. One eye was treated with the WaveLight Allegretto Wave Eye-Q 400-Hz excimer laser (Alcon Laboratories, Inc., Hünenberg, Switzerland) and the other was treated with the VISX Star S4 IR CustomVue excimer laser (Abbott Medical Optics, Santa Ana, CA). Patients completed a questionnaire assessing quality of vision and visual symptoms preoperatively and at postoperative months 1, 3, 6, and 12. The Allegretto system demonstrated non-statistically significant superiority in several subjective parameters as early as 1 month after surgery. At 12 months, there was better clarity during the day (P = .001) in the Allegretto group. Subgroup analyses were performed on eyes with preoperative higher order aberrations of 0.3 µm or less and in patients with preoperative higher order aberrations greater than 0.3 µm. In subgroup analysis, there were no differences between the two systems in eyes with low higher order aberrations or high higher order aberrations. Patients did not express any preference for one system over the other when surveyed at 1 year postoperatively. One year after surgery, there were no differences in self-reported quality of vision outcomes with the exception of better clarity of vision during the day in the eyes treated with the Allegretto system. Patients did not express any preference for one treatment modality over the other.

Treatment of mixed astigmatism: early clinical outcomes withWaveLight and Technolas excimer lasers.

We aimed to compare the results of WaveLight Allegretto Wave Eye-Q 400 Hz and Technolas 217z100 excimer lasers in the treatment of mixed astigmatism. Forty-nine patients who underwent laser in situ keratomileusis for mixed astigmatism were included in this retrospective study. Twenty-eight eyes of 21 patients were treated with WaveLight and 46 eyes of 28 patients were treated with the Technolas excimer laser. The patients' visual acuities and refractive values were evaluated on postoperative day 1 and at 1 and 3 months. In the WaveLight and Technolas groups, cylindrical refractive errors at month 3 were -0.92 ± 0.28 D and -0.88 ± 0.46 D, respectively. Spherical equivalent values for the groups at month 3 were -0.38 ± 0.73 D and -0.33 ± 0.20 D, respectively. There was no significant difference in postoperative uncorrected distance visual acuity at month 3 between the two groups (P = 0.671). At postoperative month 3, 70% of patients treated with WaveLight and 100% of patients treated with Technolas had an uncorrected distance visual acuity of 20/25 or better (P = 0.211). There were no significant differences in refraction and visual acuity between the WaveLight and Technolas groups during a 3-month follow-up period after laser in situ keratomileusis for mixed astigmatism.

Photorefractive keratectomy for myopia and myopic astigmatism correction using the WaveLight Allegretto Wave Eye-Q excimer laser system

To analyze photorefractive keratectomy (PRK) outcomes in myopia and myopic astigmatism correction using the WaveLight Allegretto Wave Eye-Q(®) excimer laser system (WaveLight Laser Technologie AG, Erlangen, Germany). 222 eyes of 151 patients underwent PRK (mean age 33.5 ± 6.8 years). Pre-operative best spectacle-corrected visual acuity (BSCVA) ranged from 0.4 to -0.1 logMAR (mean -0.03 ± 0.06). Mean spherical equivalent (SE) was -3.29 ± 1.20 D. Efficacy, predictability and safety were evaluated. Minimum follow-up was 3 months. Accountability at 3 and 6 months was 100 and 54 %, respectively (median follow-up 5 months, mean 5.2 ± 2.6 months). At 3 months, mean uncorrected visual acuity (UCVA) was -0.02 ± 0.07 logMAR, BSCVA -0.03 ± 0.05 logMAR, efficacy index 0.98 and safety index 1.02. UCVA was ≥20/16 in 40.1 %, ≥20/20 in 86.5 % and ≥20/25 in 98.2 %. Mean SE was -0.02 ± 0.20 D. Residual refractive error was ± 0.13 D in 81.5 %, ± 0.25 D in 88.7 % and ± 0.50 D in 97.7 %. At 6 months, outcomes were similar: mean UCVA was -0.02 ± 0.07 logMAR, BSCVA -0.03 ± 0.06 logMAR, efficacy index 1.00 and safety index 1.03. UCVA was ≥20/16 in 43.7 %, ≥20/20 in 86.6 % and ≥20/25 in 96.6 %. Mean SE was -0.02 ± 0.17 D. Residual refractive error was ± 0.13 D in 86.6 %, ± 0.25 D in 93.3 % and ± 0.50 D in 98.3 %. Refractive stability was achieved at 3 months. No patient lost more than one line of BSCVA. There were no retreatments. The WaveLight Allegretto Wave Eye-Q is effective, predictable and safe in low-to-moderate myopia and myopic astigmatism PRK correction.

Optimized Femto-LASIK Maintains Preexisting Spherical Aberration Independent of Refractive Error

To report the visual outcomes and change in spherical aberration in the first cohort of eyes treated at the Cole Eye Institute using the FS200 laser (Alcon Laboratories Inc). A chart review was performed on 100 eyes targeted for emmetropia with wavefront-optimized femto-LASIK using the WaveLight Allegretto Wave Eye-Q (Alcon Laboratories Inc) and FS200 lasers. Patients were subdivided into low (< -3.00 D, n = 23), moderate (-3.00 to -6.00 D, n = 45), and high myopia (> -6.00 D, n = 2). Pre- and 3- to 9-month postoperative wavefront aberrometry and uncorrected distance visual acuity (UDVA) were compared. An increase was found in spherical aberration of 0.03 +/- 0.02 microm (P = .14) for low myopia, but decreases were found of 0.01 +/- 0.01 microm (P = .45) for moderate myopia and 0.02 +/- 0.04 microm (P = .48) for high myopia. An increase in coma was noted of 0.02 +/- 0.02 microm (P = .37), 0.04 +/- 0.02 microm (P = .02), and 0.11 +/- 0.04 microm (P = .01) for low, moderate, and high myopes, respectively. An increase was found in total higher order aberrations of 0.05 +/- 0.04 microm (P = .17), 0.04 +/- 0.01 microm (P = .01), and 0.11-0.03 microm (P = .01) for low, moderate, and high myopes, respectively. Uncorrected distance visual acuity of 20/15 and 20/20 was achieved in 70% and 91% of low myopes, 58% and 93% of moderate myopes, and 34% and 78% of high myopes, respectively. Wavefront-optimized femto-LASIK with the WaveLight Allegretto Wave Eye-Q and FS200 lasers achieved excellent postoperative UDVA outcomes, with no significant induction of spherical aberration at all refractive errors.

Visante® anterior segment OCT in a patient with gas bubbles in the anterior chamber after femtosecond laser corneal flap formation

A patient with anterior chamber gas bubbles after LASIK flap formation with femtosecond laser is presented. A 33-year-old male patient had LASIK for myopia with corneal flap formation with IntraLase FS30 femtosecond laser. In the right eye, air bubbles were observed in anterior chamber after successful flap formation. Laser correction was completed successfully, by Wavelight Allegretto Wave Eye-Q excimer laser, without eye-tracker. Visante anterior segment optical coherence tomography imaging displayed that the pocket extended to limbal area, with stromal bed thickness of >600 microm at that area. We propose as possible causes of the air bubbles scattering of femtosecond laser beam producing direct photodissociation of aqueous humor, or direct cavitation effect in aqueous humor due to rapid pressure changes in corneal lamellar interface during the femtosecond laser procedure. Other causes such as migration of intrastromal bubbles through peripheral corneal stroma and trabecular meshwork, or through posterior stroma and endothelium, seem to be unlikely.

Visual and Refractive Outcomes of LASIK With the SCHWIND ESIRIS and WaveLight ALLEGRETTO Wave Eye-Q Excimer Lasers: A Prospective, Contralateral Study

To compare the safety, efficacy, and predictability of LASIK with the SCHWIND ESIRIS and WaveLight ALLEGRETTO WAVE Eye-Q excimer laser platforms. This prospective study comprised 44 eyes of 22 consecutive patients who were treated with LASIK using the Moria M2 microkeratome. One eye was treated with the SCHWIND ESIRIS laser and the fellow eye treated with the WaveLight ALLEGRETTO WAVE Eye-Q laser. All eyes operated with the SCHWIND ESIRIS were treated with standard aspheric ablation, whereas the eyes operated with the WaveLight ALLEGRETTO WAVE Eye-Q received treatment with three different ablation types according to the common practice at our clinic. Outcome measures were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and proximity to target refraction at 6-month follow-up. At 6 months postoperative, mean decimal UCVA was 0.96+/-0.22 (range: 0.3 to 1.2) for ESIRIS eyes and 0.98+/-0.17 (range: 0.6 to 1.2) for ALLEGRETTO eyes (P=.57). Mean postoperative spherical equivalent refraction was -0.02+/-0.28 diopters (D) (range: -0.75 to +0.75 D) for ESIRIS eyes and 0.11+/-0.91 D (range: -1.00 to +3.88 D) for ALLEGRETTO eyes (P=.49). Of the ESIRIS eyes, 20/22 (91%) were within +/-1.00 D of target refraction and 20/22 (91%) were within +/-0.50 D of target refraction. Of the ALLEGRETTO eyes, 20/22 (91%) and 19/22 (86%) were within +/-1.00 D and +/-0.50 D, respectively, of target refraction. No patient lost > or =2 lines of BSCVA in either group. No differences were seen in safety and efficacy outcome parameters between the SCHWIND ESIRIS and WaveLight ALLEGRETTO WAVE Eye-Q excimer lasers when used according to a previously established treatment algorithm at our clinic in the treatment of refractive error.