Corneal wavefront-guided LASIK retreatments for correction of highly aberrated corneas following refractive surgery.
OBJECTIVE
To investigate the safety and efficacy of customized corneal wavefront-guided retreatment in symptomatic patients with highly aberrated corneas following LASIK.


METHODS
This prospective study included 75 eyes of 59 patients with significant visual symptoms who underwent LASIK for the correction of residual refractive error. Ablation profiles were calculated using CSO corneal topography and ESIRIS/Schwind laser platform. Eyes were divided into two groups: those with significant night vision symptoms (37 eyes; night symptoms group) and those with decentration, irregular ablation profile, and flap complications (38 eyes; corneal complications group). Corneal topography and aberrations, visual acuity, point spread function (PSF), refractive outcome, and subjective symptoms were evaluated preoperatively, and 1, 3, and 6 months postoperatively.


RESULTS
Mean uncorrected visual acuity was 20/32 preoperatively and 20/25 at 6 months postoperatively in the night symptoms group and 20/40 preoperatively and 20/30 at 6 months postoperatively in the corneal complications group. Mean best spectacle-corrected visual acuity was 20/25 both preoperatively and 6 months postoperatively in both groups (t test, P = .219 and P = .149 for the night symptoms and corneal complications groups, respectively). Safety index was 1.1 in both groups, and efficacy index was 0.93 and 0.92, respectively. Statistically significant improvement of total corneal higher order aberrations, tilt, and improvement of spherical aberrations and coma were observed, with corresponding improvement of PSF.


CONCLUSIONS
Corneal wavefront-guided LASIK retreatment with CSO topography, ORK-W software, and ESIRIS/Schwind laser platform is safe and effective for treating symptomatic patients affected by corneal higher order aberrations or corneal irregularities following LASIK surgery.
Alió
Jorge
J
Instituto Oftalmológico de Alicante Vissum Corporation and Department of Ophthalmology, Miguel Hernández University, Alicante, Spain. jlalio@vissum.com
Galal
Ahmed
A
Montalbán
Raúl
R
Piñero
David
D
D000328:Adult; D003315:Cornea / Q000601:surgery*; D019781:Corneal Topography / Q000379:methods*; D005260:Female; D019466:Glare; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008297:Male; D009216:Myopia / Q000601:surgery*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D014792:Visual Acuity / Q000502:physiology