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Ray tracing guided myopic laser in situ keratomileusis – real world clinical outcomes

J Cataract Refract Surg. 2023 Aug 14. doi: 10.1097/j.jcrs.0000000000001286. Online ahead of print.

ABSTRACT

PURPOSE: To assess effectiveness of individualized ray-trace based laser in situ keratomileusis (ray-trace LASIK) for correction of myopia in everyday clinical practice.

SETTING: Single site private practice.

DESIGN: Retrospective nonrandomised unmasked chart review.

METHODS: Consecutive, myopic eyes (range -8.25D sphere; astigmatism 0 to -4.25 D) treated with ray-trace LASIK were included. Patients underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap (Alcon) diagnostic device. The ray-trace based algorithm (InnovEyes algorithm, Alcon) then generated an individualized 3D eye model and calculated a customized LASIK ablation profile. Postoperative visual acuity, refractive error and whole eye higher-order aberrations (HOA) were evaluated over 3 months.

RESULTS: The procedure was performed on 400 eyes (200 patients). Mean preoperative manifest refraction spherical equivalent (MRSE) was -3.39±1.58D (OD-3.84±1.63D, OS -3.98±1.75D). At Month 3, UDVA was ≥20/20 in all eyes, ≥20/16 in 89% (OD 90%, OS 89%), ≥20/12 in 51% (54% OD; 47% OS), and 20/10 in 8% (OD 8%; OS 9%) of eyes respectively. UCVA was within 1 line of preoperative CDVA in 98% of eyes (OD 98.5%; OS 98%) and 39% of eyes (OD 38%; OS 39%) gained 1 line improvement. There was a statistically but not clinically significant increase in total HOA (OD 0.06 ±0.133μm; OS 0.057±0.125μm; p<0.001). The spherical aberration decreased (OD-0.047±0.095μm, p<0.001; OS-0.051±0.091μm, p<0.001).

CONCLUSION: Ray-trace LASIK was safe and effective for correction of myopia with and without astigmatism. Approximately, half the eyes achieved ≥20/12.5 UCDVA and 8% achieved 20/10. There was no clinically significant increase in total whole eye HOA.

PMID:37595291 | DOI:10.1097/j.jcrs.0000000000001286

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