Wavefront-guided ablation with Bausch and Lomb Zyoptix for retreatments after laser in situ keratomileusis for myopia.
OBJECTIVE
To evaluate the efficacy of wavefront-guided ablation for treatment of residual refractive error and higher order aberrations after laser in situ keratomileusis (LASIK) for myopia.


METHODS
Twenty-one eyes of 13 patients with residual refractive error after myopic LASIK were treated with a wavefront-guided ablation with the Zyoptix technique. In 13 eyes of 8 patients (Group A) we lifted the flap with an epitheliorhexis technique; in 8 eyes of 5 patients (Group B) we cut a new flap with a Hansatome microkeratome.


RESULTS
Preoperative root mean square (RMS) values were 1.370 for second order aberrations, 0.382 for total higher order aberrations, 0.273 for third order, 0.243 for fourth order, and 0.052 for fifth order aberrations. Three months postoperatively, RMS values decreased significantly to 0.278 (second order), 0.189 (total higher order), 0.138 (third order), 0.107 (fourth order), and 0.038 (fifth order). Ablation depth was two times greater than needed with a standard Planoscan treatment. Patients in the microkeratome recut group showed a trend toward overcorrection, and residual astigmatism was higher (-0.75 +/- 0.58 D) than in the flap lift group (-0.25 +/- 0.29 D).


CONCLUSIONS
Wavefront-guided ablation was an effective method to correct residual refractive error and higher order aberrations after myopic LASIK. Functional and refractive outcomes were better when we lifted the flap than when we recut the flap.
Castanera
Jorge
J
Instituto de Oftalmología Castanera, Barcelona, Spain.
Serra
Alicia
A
Rios
Carlos
C
D000328:Adult; D019781:Corneal Topography; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D012029:Refraction, Ocular; D019233:Retreatment; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity