Decision Assistant Wizard to standardize optimal outcomes in excimer laser refractive corneal surgery.
OBJECTIVE
To assess a decision tree analysis system to further optimize refractive surgery outcomes.


METHODS
A 5-step decision tree, the Decision Assistant Wizard, based on previous experience with the SCHWIND AMARIS laser, was applied for selecting a customized refractive surgery treatment mode (aspheric aberration neutral, corneal wavefront-guided, or ocular wavefront-guided) to eliminate or reduce total aberration.


RESULTS
Using the Decision Assistant Wizard, 6467 LASIK treatments were performed over a 30-month period; 5262 and 112 for myopic and hyperopic astigmatism, respectively, using aspheric aberration neutral (AF) profiles, 560 using corneal wavefront-guided profiles, and 533 using ocular wavefront-guided profiles. Twenty-two (0.3%) retreatments were performed overall; 18 (0.3%) and 0 (0%) after myopic and hyperopic astigmatism, respectively, using AF, 3 (0.5%) after corneal wavefront-guided profiles, and 1 (0.2%) after ocular wavefront-guided profiles.


CONCLUSIONS
Decision Assistant Wizards may further optimize refractive surgical outcomes by providing the most appropriate ablation pattern based on an eye's anamnesis, diagnosis, and visual demands. The general principles may be applied to other laser systems; however, specifics will depend on manufacturers' specifications.
Arbelaez
Maria Clara
MC
Muscat Eye Laser Center, Muscat, Sultanate of Oman. drmaria@omantel.net.om
Ewering
Tobias
T
Arba Mosquera
Samuel
S
D057128:Aberrometry; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D003315:Cornea / Q000503:physiopathology; D019781:Corneal Topography; D003663:Decision Trees; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000592:standards*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D012029:Refraction, Ocular / Q000502:physiology; D016896:Treatment Outcome