Minimizing%20higher%20order%20wavefront%20aberrations%20with%20custom%20LASIK%20treatment

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Minimizing higher order wavefront aberrations
with custom LASIK treatment

• Stephen G. Slade

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Financial Disclosure

• Consultant and Medical Monitor for Bausch Lomb

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Optimizing LASIK Outcomes

• Current LASIK systems do an excellent job of
  correcting MRSE
• To improve patient quality of vision, must go
  beyond MRSE
• Higher-order wavefront aberrations can create
  problems such as decreased contrast sensitivity
  or night vision, glare, shadows, and halos.
• Standard LASIK treatments can increase HOAs

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Methods

• All eyes treated for myopia with the Zyoptix
  System for Personalized Vision Correction
  (Zyoptix) using the Technolas 217z excimer laser
  as part of the Zyoptix FDA trial
• Sub-group analyses of wavefront aberrations

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Effect of Wavefront-guided LASIK on HOAs

• Higher Order Aberration (HOA) sub-study
• N80 eyes
• Bilateral treatment for myopia
• One eye received PlanoScan treatment
• Fellow eye received Zyoptix wavefront-guided
  treatment

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Wavefront-guided LASIK Minimizes Induction of
Higher Order Aberrations

• Comparison of Post- to Pre-treatment HOAs
• All HOAs
• PlanoScan eyes 45 increase in HORMS
• Zyoptix eyes only 14 increase in HORMS
• Third order HOAs (coma, trefoil)
• Coma trefoil are majority (59) of all postop
  HOA
• PlanoScan eyes 30 increase in 3rd order HOA
• Zyoptix eyes 16 decrease in 3rd order HOA

Porter et al. J Opt Soc Am. 2001. 181793
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Effects of Optical Zone Size

• Optical Zone (OZ) sub-group analysis
• N340 eyes
• Assessed change in Visual Symptoms
• Assessed change in HOAs

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Percent of Cases Better or Significantly
Better after Zyoptix Treatment
Subjective Visual Symptoms (n340) 6.0 mm OZ 6.5 mm OZ 7.0 mm OZ
Halos 6.8 14.6 20.0
Light Sensitivity 21.9 29.4 55.0
Blurring of Vision 16.5 21.9 45.0
Fluctuation of Vision in Dim Light 20.5 26.1 30.0
Larger OZ provides better visual outcome
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Increased Treatment OZ Decreases Induction of
HOAs(for eyes with SE between -4 D and -5 D)
n70
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Summary

• Wavefront-guided LASIK treatment minimizes
  induction of HOAs, particularly 3rd order HOAs,
  compared to standard LASIK
• Large customized OZ groups (6.5-7.0 mm) had more
  reports of improvement in visual symptoms post
  treatment compared to standard OZ group (6.0 mm)
• Large customized OZ groups (6.5 7mm) had reduced
  mean HOAs compared to the standard OZ group (6.0
  mm)

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Conclusion

• There is potential for improving visual outcomes
  after LASIK by customizing optical zone size in
  conjunction with wavefront-guided treatment