Topographic- and Wavefront-guided Customized Ablations With the NIDEK-EC5000CXII in LASIK for Myopia

Kermani, Omid; Schmiedt, Karl; Oberheide, Uwe; Gerten, Georg
October 2006
Journal of Refractive Surgery;Oct2006, Vol. 22 Issue 8, p754
Academic Journal
PURPOSE: To assess refractive outcomes, changes in the total higher order root mean square (RMS) aberration, and changes in higher order wavefront aberrations after LASIK for myopia and myopic astigmatism with the NIDEK Advanced Vision Excimer Laser platform (NAVEX) using either an aspheric or topography-based or whole eye wavefront ablation algorithm. METHODS: This was a retrospective study of 1459 eyes that underwent LASIK for myopia and myopic astigmatism. The mean preoperative spherical equivalent refraction was -4.68 diopters (D) (range: -0.50 to -9.63 D) with astigmatism up to -4.50 D. Treatments were classified into three categories depending on the type of ablation algorithm used--optimized aspheric transition zone (OATz) denoted eyes that underwent aspheric treatment zones; customized aspheric treatment zone (CATz) denoted eyes that underwent customized ablations based on corneal topography; and OPDCAT denoted eyes that underwent customized ablation based on the whole eye wavefront profile. Follow-up data are reported at 3 months (69%) and 12 months (17%) postoperatively. RESULTS: Three months after LASIK, the predictability (±0.5 D from target refraction) was 80% for OATz, 91% for CATz, and 76% for OPDCAT. Of all eyes, 96% were within ±1.0 D of intended refraction 3 months postoperatively and 100% after 12 months (87% ±0.5 D). In the aspheric and custom groups, a notable improvement of uncorrected visual acuity was noted between 3 and 12 months after LASIK. No eye lost >1 line of best spectacle-corrected visual acuity. Mean higher order RMS increased in all groups. CONCLUSIONS: The data support that the treatment of myopia and myopic astigmatism is safe and effective with NAVEX. Customized ablation based on corneal topography rather than on total wavefront error was more predictable.


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