Visual, refractive, and aberrometric outcomes after customised LASIK for correcting moderate to high astigmatism in the short-term follow-up: the influence of cyclotorsion

Session Details

Session Title: LASIK II

Session Date/Time: Tuesday 25/09/2018 | 16:30-18:00

Paper Time: 16:48

Venue: Room A3, Podium 2

First Author: : R.Pérez SPAIN

Co Author(s): :    N. Gomez de Liano Salgado   F. Gomez de Liano Martinez   V. Martin Rodriguez   D. Pinero Llorens   J. Ruiz Fortes   H. Fukumitsu     

Abstract Details

Purpose:

To determine the visual and refractive outcomes and the visual quality profile in moderate to high astigmatic patients operated with the wavefront-guided (WF) LASIK technique in the short-term follow-up, and to evaluate the influence of cyclotorsion in the postoperative amount of astigmatism.

Setting:

Oftalmar. Vithas Hospital Internacional Medimar. Alicante (Spain). Centro Gómez de Liaño. Ávila (Spain)

Methods:

The study involved 23 eyes of 13 patients with astigmatism higher than 2 diopters (D). A customized ablation was programmed by means of a novel type of Hartmann-Shack (HS) aberrometer (iDesign/G3000) and the procedure was performed using the ViSX S4 platform. Prior to the surgery, a comprehensive ophthalmological examination was performed that included the characterization of the aberrometric profile and the imaging of the eye in order to evaluate the degree of cyclotorsion. The statistical analysis was performed for the whole sample and for two different groups regarding the location of the hinge, nasal (11 patients) or superior (12 patients).

Results:

Preoperative UCVA was 1.32 ±1.00 (0.30-3.00) and improved to 0.18±0.15 (0.00-0.52) (p<0.01). BCVA decreased from 0.04±0.09 (0.00-0.35) to 0.11±0.12 (0.00-0.30) (p<0.01). Efficacy index was 0.77±0.22 (0.40-1.25). Safety index was 0.87±0.17 (0.50-1.33). Astigmatic error decreased from -3.18±0.89 D (-2.00 to -5.00) to -0.67±0.31 (-1.25 to 0.00) (p<0.01). Spherical aberration (SA) changed from 0.03±0.06 (-0.10 to 0.12) to -0.07±0.20 (-0.64 to 0.17) (p>0.01). Coma minimally increased from 0.14±0.08 (0.04-0.35) to 0.20±0.13 (0.05-0.53) (p>0.01). Trefoil varied from 0.12±0.05 (0.04-0.19) to 0.20±0.15 (0.04-0.69) (p>0.01). Cyclotorsion was -0.75°±3.15 (-7.00 to +5.20). Cyclotorsion correlation with preoperative astigmatism (r=-0.19) and residual astigmatism (r=-0.07).

Conclusions:

Customized LASIK with the ViSX S4 platform combined with the iDesign HS aberrometer to operate moderate to high amount of astigmatism provides excellent visual and refractive results with high indexes of efficacy and safety in the very short-term follow up. SA, coma-like and trefoil values did not show statistically significant increase in the postoperative period in any case (nasal or superior hinge). Nasal hinges induced higher values of SA and coma-like aberration compared to those with superior hinges although this difference was not significant. The cyclotorsion values did not show correlation with the preoperative or residual astigmatism.

Financial Disclosure:

-