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Topography-modified refraction (TMR) in wavefront optimized (WFO) myopic LVC: adjustment of treated cylinder and axis provided by multiple topography and wavefront data in cases screened-out of topo-guided and ray-tracing customized LASIK options

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First Author: F.Xhani GREECE

Co Author(s):    A. Kanellopoulos                    

Abstract Details

Purpose:

To evaluate the safety and efficacy of the adjustment of treated cylinder amount and axis (Topography-modified refraction) in the measured in manifest clinical refraction, in myopic wavefront-optimized laser vision correction

Setting:

LaserVision.gr Clinical and Research Eye Institute

Methods:

In this prospective case series study, 106 eyes of 53 patients were included: These cases considered for either topography-guided TMR or Innoveyes ray tracing LASIK customization, excluded either on the basis of irregulat placido-disc topography or irregular epithelial mapping with anterior segment OCT. The actual treatment refraction was adjusted up to 75% of additional or less cylinder amount when comparing tomography cylinder, previous spectacles to clinical manifest refraction and 75% towards the axis. The 3 months peri-operative UDVA and CDVA, residual refractive and topographic cylinder, high order aberrations, and Contrast Sensitivity were compared between all three groups.

Results:

68 eyes were treated with PRK, 38 with LASIK. 3 months peri-operative results for PRK group vs LASIK group: 3 month postoperative UDVA in decimal scale was respectively: 1.18, 1.17 in average values, residual refractive cylinder: – 0,04 D, – 0,05 D,; residual topographic cylinder: 0,39 D, 0,49 D,; high order aberrations: 0,21um, 0,48um. The differences in UDVA between the groups at the 1 decimal level were NOT statistically significant (P>.05). The differences between both PRK TMR groups compared with the LASIK TMR group were statistically significant for 2 lines of vision gained (pre-op CDVA to post-op UDVA and total high order aberrations (P < .05 for both comparisons).

Conclusions:

Manual TMR considerations and conversion of LASIK to a surface ablation based on surface normality appear to offer superior visual function outcomes with myopic WFO PRK and LASIK with minimal differences between the two

Financial Disclosure:

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