Factors predicting successful customized excimer laser treatment in irregular corneas. Issue 2 (February 2020)

• Record Type: Journal Article
• Authors: Hanna, Rana; Mimouni, Michael; Plaza, Ana Belen; Alió, Jorge L.
• Is Part Of: Journal of cataract and refractive surgery. Volume 46:Issue 2(2020)
• Page Start: 241
• Page End: 249
• Publication Date: 2020-02
• Subjects: 617.7
• DOI: 10.1097/j.jcrs.0000000000000043
• Languages: English
• ISSNs: 0886-3350

Abstract

Abstract : This study highlights the main factors that predict a successful WG-CT in highly aberrated corneas both in lowering HOAs and in the refractive predictability. Abstract : Purpose: To identify factors associated with a successful wavefront-guided customized treatment (WG-CT) with an excimer laser in highly aberrated corneas. Setting: VISSUM Alicante Spain. Design: Retrospective consecutive noncomparative case series. Methods: Treatment was performed with the WG-CT Amaris excimer laser using the ORK-CAM software for the calculation of the ablation profile. Eyes of patients with significantly aberrated corneas, including postrefractive and keratoplasty procedures or high irregular astigmatism with significant higher-order aberrations (HOAs) that had WG-CT were included. Refractive outcomes, HOAs, and visual outcomes were recorded. Statistical analysis was performed to identify factors associated with technical (based on HOAs) or refractive outcome success. Results: The study included 55 treatments of 51 eyes (35 patients). The postoperative uncorrected distance visual acuity was 0.2 logarithm of the minimum angle of resolution or better in 72% of the eyes, and the postoperative residual manifest refraction spherical equivalent was ±0.50 diopter in 56% of the eyes, whereas 11% of the eyes lost 1 line or more in corrected distance visual acuity. Successful reduction in the total root mean square (RMS) of HOAs occurred in 36 eyes (65%), and these eyes had a significantly higher preoperative RMS of HOAs (1.45 ± 0.93 μ vs 0.91 ± 0.34 μ, P = .003) and preoperative coma-like aberrations (1.09 ± 0.83 μ vs 0.55 ± 0.28 μ, P = .001). In multivariate analysis, posthyperopic treatment eyes were less likely to achieve refractive outcome success (odds ratio = 0.09, P = .02). Conclusions: WG-CT in highly aberrated corneas had a limited refractive predictability. Eyes with preoperative coma-like aberrations are more likely to benefit from a reduction in HOAs. Posthyperopic treatment is associated with a higher rate of refractive surprises.