Minimizing higher order wavefront aberrations with custom LASIK treatment

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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
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