Femtosecond LASIK with iDesign aberrometer yields stable outcomes at 1 year

Wavefront-guided femtosecond laser-assisted LASIK with a new-generation aberrometer yielded sustained improvements in visual acuity and refractive error, according to a study.

Perspective from Soosan Jacob, MS, FRCS, DNB; and Amar Agarwal, MS, FRCS, FRCOphth

The prospective study included 50 eyes of 25 patients who underwent aberrometry with the iDesign advanced WaveScan aberrometer (Abbott Medical Optics), femtosecond laser-assisted flap creation and excimer laser ablation.

Mean sphere, cylinder and spherical equivalent improved from –4.29 D, –0.75 D and –4.67 D, respectively, to 0.03 D, –0.09 D and –0.02 D at 12 months. The improvements were statistically significant (P < .001).

Attempted and achieved spherical equivalent correction correlated significantly at 12 months (P < .001). Postoperative spherical equivalent was within 0.5 D of the target in 98% of eyes.

Mean spherical equivalent had a slight but significant myopic shift from 1 month to 3 months postoperatively but was stable at subsequent visits.

LogMAR mean corrected distance visual acuity improved from 0.07 to –0.07 (P < .01), and no eyes lost lines of corrected distance visual acuity.

LogMAR uncorrected distance visual acuity at 12 months was 0.0 or less in 94% of eyes and 0.3 or less in 100% of eyes.

Additionally, 47 eyes (94%) had astigmatism within 0.25 D of the target at 1 year.

There was a mild, insignificant increase in higher-order aberrations after surgery, but values stabilized during follow-up.

No flap-related intraoperative complications were reported. – by Matt Hasson

Disclosure: The authors report no relevant financial disclosures.

Perspective

Soosan Jacob, MS, FRCS, DNB; and Amar Agarwal, MS, FRCS, FRCOphth

Wavefront-guided LASIK has been shown in multiple studies to be a safe and effective option. However, the technology is highly dependent on the quality of data capture. Recently, a more advanced aberrometer, iDesign (Abbott Medical Optics), has come into the commercial space. It has five times higher resolution than its predecessor, the Wavescan (Abbott Medical Optics), and, like its predecessor, uses a Fourier reconstruction algorithm and Hartmann-Shack technology. In a long term (1-year) study, Dr. Gaurav Prakash, who is a well-known academician in the field, has, with his colleagues at NMC Specialty Hospital, Abu Dhabi, looked at the outcomes and stability of wavefront-guided, femtosecond-assisted Lasik using data capture with iDesign. Out of the 50 eyes, 94% achieved a 12-month UDVA of 20/20 or better and 100% achieved 20/40 or better, compared to a preoperative CDVA of 20/20 or worse in 54% of cases only. Postoperative SEQ was within ±0.5 D in 98% of eyes. No cases lost CDVA. Alpins’ analysis for astigmatism showed good results. There was only a mild, non-significant increase of higher-order aberrations after surgery, and the postoperative wavefront was stable on follow-up over the year. Finally, on historical comparison, the authors concluded that iDesign wavefront-guided LASIK is better in safety, efficacy and UDVA achieved in percentage terms compared to the predecessor aberrometer.

Soosan Jacob, MS, FRCS, DNB; and Amar Agarwal, MS, FRCS, FRCOphth

OSN APAO Edition Board Members

Disclosures: Jacob reports no relevant financial disclosures. Agarwal reports he is a consultant for Abbott Medical Optics.

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Source:

Prakash G, et al. J Refract Surg. 2015;doi:10.3928/1081597X-20150820-05.