Ray-tracing-guided myopic LASIK: real-world clinical outcomes

J Cataract Refract Surg. 2023 Nov 1;49(11):1140-1146. doi: 10.1097/j.jcrs.0000000000001286.

Abstract

Purpose: To assess effectiveness of individualized ray-trace based laser in situ keratomileusis (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 ≤-8.25 diopters [D] sphere; astigmatism 0 to -4.25 D) treated with ray-trace based LASIK were included. Patients underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap diagnostic device. The ray-trace based algorithm (InnovEyes algorithm) 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 (HOAs) were evaluated over 3 months.

Results: The procedure was performed on 400 eyes (200 patients). Mean preoperative manifest refraction spherical equivalent was -3.39 ± 1.58 D (right eye -3.84 ± 1.63 D, left eye -3.98 ± 1.75 D). At month 3, uncorrected distance visual acuity (UDVA) was ≥20/20 in all eyes, ≥20/16 in 89% (right eye 90%, left eye 89%), ≥20/12 in 51% (54% right eye; 47% left eye), and 20/10 in 8% (right eye 8%; left eye 9%) of eyes respectively. UDVA was within 1 line of preoperative corrected distance visual acuity in 98% of eyes (right eye 98.5%; left eye 98%) and 39% of eyes (right eye 38%; left eye 39%) gained 1 line improvement. There was a statistically but not clinically significant increase in total HOAs (right eye 0.06 ± 0.133 μm; left eye 0.057 ± 0.125 μm; P < .001). The spherical aberration decreased (right eye -0.047 ± 0.095 μm, P < .001; left eye -0.051 ± 0.091 μm, P < .001).

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

MeSH terms

  • Astigmatism* / etiology
  • Astigmatism* / surgery
  • Cornea / surgery
  • Corneal Wavefront Aberration* / diagnosis
  • Humans
  • Keratomileusis, Laser In Situ* / methods
  • Lasers, Excimer / therapeutic use
  • Myopia* / etiology
  • Myopia* / surgery
  • Refraction, Ocular
  • Retrospective Studies
  • Treatment Outcome