This article is more than 5 years old. Information may no longer be current.
Custom LASIK tops conventional LASIK in study
While all groups fared well, the custom group had the highest BCVA and was within target refraction.
KUALA LUMPUR – Postoperative refraction and improvement in best corrected visual acuity were better with customized LASIK than with conventional LASIK in a study performed in Thailand.
Anun Vongthongsri, MD, director of the Laser Vision LASIK Center in Bangkok, conducted a clinical study in which he compared three custom software options on the Nidek excimer laser to conventional ablation.
In addition to conventional ablation, he used the NAVEX optimized aspheric treatment zone (OATz), the customized aspheric treatment zone (CATz) and the optimized path difference customized aspheric treatment (OPDCAT).
Dr. Anun presented his results at a Nidek-sponsored symposium held during the Asia-Pacific Academy of Ophthalmology meeting here.
Study results
The nonrandomized prospective study included 382 eyes of 216 patients with a mean preoperative refraction of –4.44 D. Patients ranged in age from 19 to 62 years old. The mean follow-up was 3.6 months, ranging from 3 to 8 months.
Dr. Anun said that he used the Nidek OPD scan, the Nidek CX2 excimer laser and the Nidek MK2000 microkeratome to perform the procedures.
He performed conventional LASIK in 112 eyes, OATz in 137 eyes, OPDCAT in 106 eyes and CATz in 27 eyes.
Preoperatively, BCVA was 20/20 or better in 83.9% of patients in the conventional group, 81% of patients in the OATz group, 57% of those in the CATz group and 85% in the OPDCAT group, according to Dr. Anun.
Mean preop refractive error ranged from –4.11 D in the conventional group to –5.45 D in the OATz group. Patients treated with the CATz had a mean preop refractive error of –4.69 D, and those treated with the OPDCAT had a mean preop refractive error of –4.5 D.
Postoperatively, BCVA was 20/20 or better in about the same number of patients (86.5%) as preop in the conventional LASIK treatment group, while in the customized groups the percentages rose to 92.7% in the OATz group, 85.7% in the CATz group and 97.1% in the OPDCAT group.
“All groups had good results. All groups had 100% postoperative uncorrected visual acuity equal to or greater than 20/40. All groups has a gain in BCVA of 7% to 43%, with the conventional LASIK gaining less than the other groups,” Dr. Anun concluded.
About 85% of the conventional patients were within 0.5 D of the attempted refraction, about 95% of the OATz and CATz groups were within 0.5 D, and 100% of the OPDCAT group were within 0.5 D.
In context
Dr. Anun, who has been using customized LASIK for 2 years, said that if it were up to him, he would apply it to all cases. But he said that it is up to the patients to decide once they hear the pros and cons of the different treatment profiles, as well as the differences in prices.
In his practice, he uses customized ablation for 80% of his patients, while it accounts for only about 50% of cases throughout Thailand. But he has high hopes that customized ablation will only gain in popularity.
“The LASIK here in the future would be nearly all done by customized ablation,” he predicted.
For Your Information:
- Anun Vonthongsri, MD, can be reached at the Department of Ophthalmology, Ramathibodi Hospital School of Medicine, Bangkok 10400, Thailand; +66-2-201-1560; fax: +66-2-201-1516; e-mail: raawt@mahidol.ac.th.
- David W. Mullin is Managing Editor of the Europe/Asia-Pacific Edition. Jared Schultz is an OSN Staff Writer who covers all aspects of ophthalmology. He focuses geographically on Europe and the Asia-Pacific region.