Incremental improvements in technology improve patient outcomes

CHICAGO — Technological improvements in refractive surgical equipment have led to faster treatment, better registration and a better ability to compensate for pupil centroid shift, according to a surgeon speaking here.

“Incremental improvements in technology” have reduced the amount of higher-order aberrations surgeons induced during refractive surgery and, therefore, have given patients better quality of vision, said Steven C. Schallhorn, MD. He spoke here during the American Academy of Ophthalmology meeting.

Technology improvements have allowed surgeons to correct mixed astigmatism, higher myopia and even hyperopia, he said. Refractive lens exchange with toric IOLs has “excellent results” as well, he said.

“About the same percentage of patients are 20/20 or 20/26 when they’re implanted with a toric IOL or when they’ve undergone wavefront-guided treatment,” he said.

Other advances seen in the past year include better iris and scleral recognition software on laser refractive systems and better flap creation technology, Dr. Schallhorn said.

“We can’t neglect the influence of the flap on outcomes,” he said. “More and more studies are showing that. The thinner flap we’re now able to make allows a wider range of treatment indications.”

He called the femtosecond laser keratome a “significant improvement” from blade technologies.

“Faster treatment times are just as important,” Dr. Schallhorn said. Faster treatment time should improve outcomes because it lessens corneal hydration variability and allows better patient fixation.

In the future, Dr. Schallhorn said, he would like to see better cyclotorsional eye tracking and customized treatments based on individual corneal biomechanics.