Initial Outcomes with Customized Myopic LASIK, Guided by Automated Ray Tracing Optimization: A Novel Technique

• Main Author: Kanellopoulos AJ
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-11-01
• Series: Clinical Ophthalmology
• Subjects: ray tracing excimer customization; topography-guided; wavefront-guided; femtosecond-laser assisted myopic lasik; customized excimer ablation
• Online Access: https://www.dovepress.com/initial-outcomes-with-customized-myopic-lasik-guided-by-automated-ray--peer-reviewed-article-OPTH

Anastasios John Kanellopoulos1,2 1Laservision.gr Clinical and Research Institute, Athens, Greece; 2NYU Medical School, Department of Ophthalmology, New York City, NY, USACorrespondence: Anastasios John KanellopoulosLaservision.gr Clinical and Research Institute, 17 Tsocha Street, Athens 115 21, GreeceTel + 30 210 7472777Fax + 30 210 7472789Email [e-mail]: Safety and efficacy of a novel automated ray tracing optimization in customization of excimer ablation in myopic LASIK.Methods: In a consecutive case series, 25 patients (50 eyes) undergoing femtosecond-laser-assisted myopic LASIK were evaluated. The novel, artificial-intelligence platform initially calculates the ablation profile based on a model eye for each case, based on interferometry axial length data. Low- and high-order aberration calculation is performed by raytracing based on wavefront and Scheimpflug tomography measurements, all from a single diagnostic device. Visual acuity, refractive error, keratometry, topography, high-order aberrations and contrast sensitivity were evaluated, over six months follow-up.Results: Change from pre- to 6 months post-operative: mean refractive error improved from − 5.06 ± 2.54 diopters (D) (range − 8.0 to − 0.50 D) to − 0.11 ± 0.09 D (range − 0.25 to + 0.25); refractive astigmatism from − 1.07 ± 0.91 D (range − 4.25 to 0 D) to − 0.15 ± 0.04 D (range − 0.25 to 0); and topographic astigmatism from − 1.65 ± 0.85 D to − 0.26 ± 0.11 D (range − 0.60 to 0). About 65% of eyes gained one line of vision and 38% 2 lines. Pre- to post-operative high-order aberration average: RMSh changed from 0.25 um to 0.35 um. Contrast sensitivity improved post-operatively.Conclusion: We report safe and effective preliminary outcomes with a novel excimer laser customization by ray tracing optimization, for myopic LASIK treatments, employing several independent up-till-now diagnostics and a customized eye model reference for each case. It bears the potential advantage through total eye aberration data and ray tracing refraction calculation to offer improved and more predictable visual outcomes.Keywords: ray tracing excimer customization, topography-guided, wavefront-guided, femtosecond-laser assisted myopic LASIK, customized excimer ablation