title: Corneal wavefront-guided enhancement for high levels of corneal coma aberration after laser in situ keratomileusis.
abstract: OBJECTIVE
  To evaluate the improvement in visual and optical performance after corneal wavefront-guided laser in situ keratomileusis (LASIK) enhancement in patients with high levels of corneal coma aberration and complaints about quality of vision.
  
  
  METHODS
  Vissum-Instituto Oftalmológico de Alicante, Alicante, Spain.
  
  
  METHODS
  Corneal wavefront-guided LASIK enhancement was performed in 34 symptomatic eyes of 29 patients aged 26 to 64 years with previous LASIK surgery and a significant level of primary coma aberration. The ablation design was calculated using ORK-CAM software (Schwind eye-tech-solutions). The follow-up period was 6 months. Changes in refraction, corneal aberrometry, and subjective symptoms were analyzed.
  
  
  RESULTS
  At 6 months, the mean efficacy index was 0.88 +/- 0.12 and the mean safety index, 1.03 +/- 0.16. The reduction in sphere and cylinder at 1 month was statistically significant (P<.01). Of all eyes, 97.06% had a spherical equivalent within +/-1.00 diopter. At 1 month, statistically significant changes were observed: total (P = .01), and primary coma root mean square reduction (P<.01), and negativization of the primary spherical aberration coefficient (P<.01). At 6 months, patient perception of halos and glare was reduced or eliminated in a high percentage of cases.
  
  
  CONCLUSIONS
  Corneal wavefront-guided enhancements with the ORK-CAM system are a useful tool for the correction of the second order refractive errors and for the reduction of the corneal primary coma induced by previous keratorefractive procedures.
authors.affiliation: Vissum-Instituto Oftalmológico de Alicante, Alicante, Spain. jlalio@vissum.com
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.forename: David P
authors.initials: DP
authors.lastname: Piñero
authors.forename: Ana Belén
authors.initials: AB
authors.lastname: Plaza Puche
mesh_terms: D000328:Adult; D019781:Corneal Topography; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009216:Myopia / Q000209:etiology / Q000601:surgery*; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D014792:Visual Acuity / Q000502:physiology