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Fulfilling the Promise of Laser Refractive Surgery
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PURPOSE
To review the characteristics required to perform accurate and precise laser refractive surgery relative to the current state of the art and the technology improvements needed in the future.
METHODS
The general characteristics for laser refractive surgery are identified and their relative contributions to a successful result considered. For each characteristic, the degree to which improvements in technology are likely to improve results is discussed.
RESULTS
The environment (surgeon, site), technology (laser, aberrometer), and patient are identified as key factors affecting results. Although aberrometers appear to be clinically sufficient, improvements in laser beam characteristics and delivery should improve system consistency. Current registration technology may be a factor in variability from patient to patient, but the greatest contribution in this regard would appear to be patient biomechanical and healing response factors.
CONCLUSIONS
Wavefront-guided laser refractive surgery has demonstrated an ability to be better than conventional surgery. Improvements in laser technology, registration technology, and biomechanical diagnostics are expected to further improve results. These potential improvements are expected to reduce variability and suggest that the final potential of this technology has not yet been realized. [J Refract Surg. 2006;22:S965-S968.]
AUTHORS
From The Eye Institute, Chatswood, NSW, Northern Sydney Area Health Service, and the University of Sydney, Australia (Lawless); and Refractive R&D, Alcon Laboratories Inc, Ft Worth, Tex (Potvin).
Dr Lawless is a consultant to Alcon Laboratories Inc and IntraLase. Dr Potvin is an employee of Alcon Laboratories Inc.
Correspondence: Michael A. Lawless, 270 Victoria Ave, Level 3,Chatswood NSW 2067, Australia. Tel: 61 2 9424 9999; Fax: 61 2 9410 3000; E-mail: mlawless@theeyeinstitute.com.au