title: Wavefront-guided treatment of abnormal eyes using the LADARVision platform.
abstract: OBJECTIVE
  To evaluate the clinical results of Alcon LADARVision4000 wavefront-guided customized treatment of eyes with myopia and/or astigmatism, and clinically significant visual symptoms related to the presence of higher order aberrations.
  
  
  METHODS
  Seven consecutive abnormal eyes from seven patients underwent wavefront-guided CustomCornea (1 PRK, 6 enhancements after previous LASIK) to correct low and higher order aberrations, using the Alcon LADARVision4000 platform. Eyes were examined at 1 to 3 months after treatment; the longest follow-up examination was used for analysis. Uncorrected and best spectacle-corrected visual acuity, manifest refractive spherical equivalent error, and subjective visual symptoms were measured, as well as wavefront measurement of higher order aberrations.
  
  
  RESULTS
  All seven eyes had an improvement in UCVA. One eye gained 2 lines of BSCVA, four eyes gained 1 line, and no eye lost any lines. Manifest refractive spherical equivalent error was slightly hyperopic in all eyes (+0.12 to +1.50 D). All eyes showed a reduction in pre-existing higher order aberrations, ranging between 1% and 48%. Spherical aberration was reduced most (mean 38% reduction), coma was reduced by a mean 14%, and all other terms were reduced by a mean 17% compared to preoperative values. Subjectively, all patients noticed a reduction in their pre-existing visual symptoms and reported visual performance comparable to their fellow asymptomatic eye. Overall, the treatment was considered very satisfactory by patients in terms of visual quality gain.
  
  
  CONCLUSIONS
  Wavefront-guided custom ablation with Alcon's LADARVision4000 was effective in reducing higher order aberrations and related visual symptoms in this preliminary small series. Longer follow-up on more eyes is necessary to assess the accuracy of the algorithm in the correction of defocus, which resulted in a slight overcorrection in this study.
authors.affiliation: Carones Ophthalmology Center, Milan, Italy. fcarones@carones.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Carones
authors.forename: Luca
authors.initials: L
authors.lastname: Vigo
authors.forename: Elena
authors.initials: E
authors.lastname: Scandola
mesh_terms: D000328:Adult; D000465:Algorithms; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D003319:Corneal Stroma / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D013524:Surgical Flaps; D014786:Vision Disorders / Q000503:physiopathology / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology