Contact lens-intolerant patient gets LASEK

LASEK was performed with the Visx CustomVue. The patient had worn contact lenses for about 5 years.

Issue: June 15, 2005

ByW. Bruce Jackson, MD, FRCSC

History: A 41-year-old woman presented. She was tired of her dependence on glasses and recently intolerant to her soft toric contact lenses. She had worn contacts for about 5 years.

Preoperative examination:

Uncorrected visual acuity: Right eye counts fingers at 8 feet; Left eye 20/400

Manifest refraction: Right eye –5.25 +2.00 × 45; Left eye –4.75 +1.50 × 160

Best corrected visual acuity: Right eye 20/20; Left eye 20/20

Pupils: Both eyes scotopic 8.5 mm, photopic 6 mm

System:

Visx WaveScan Wavefront System (software 3.62 international), Visx Star S4-IR Excimer Laser System (software 5.01 international)

Procedure:

Visx CustomVue LASEK

Right eye –5.34 +2.18 × 43 (+5% nomogram adjustment)

Left eye –5.01 +1.64 × 161 (+5% nomogram adjustment)

Iris registration enabled. Right eye 3.4° counterclockwise adjustment; left eye 4.8° clockwise adjustment

Treatment center adjustment. Right eye 0.56 mm x axis, 0.18 mm y axis; left eye –0.25 mm x axis, 0.19 mm y axis

3 months postop refraction:

UCVA: Right eye 20/20+2; Left eye 20/15–1

Refraction: Right eye plano; Left eye plano

Lower-order aberrations (sphere and cylinder): Right eye –0.26 +1.02 × 62; Left eye –0.11 +0.31 × 136

Vertical and horizontal coma: Right eye 0.2401 µm; Left eye 0.1534 µm

Spherical aberration: Right eye 0.1714 µm; Left eye 0.0694 µm

Trefoil: Right eye 0.1688 µm; Left eye 0.1013 µm

Discussion:

Patient is pleased with the outcome thus far. There have been no subjective complaints of visual disturbances and no night vision complaints. Two letters were gained in the right eye and one line was gained in the left eye from preop BCVA compared with postop UCVA.


Preoperative topography on right. Three-month postoperative topography shown on left.

Preoperative WaveScan (OD) shown on right. Three-month postoperative WaveScan pictured on left.

Preoperative WaveScan (OS) shown on right. Three-month postoperative WaveScan pictured on left. Images: Jackson WB

For Your Information:

W. Bruce Jackson, MD, can be reached at University of Ottawa Eye Institute, 501 Smyth Road, Tower III, Room 3301, Ottawa, ON, K1H 8L6, Canada; 613-737-8759; fax: 613-737-8374; e-mail: bjackson@ottawahospital.on.ca. Dr. Jackson is a paid consultant to Visx and has had research funded by the company.