title: Three-month clinical outcomes with static and dynamic cyclotorsion correction using the SCHWIND AMARIS.
abstract: OBJECTIVE
  To evaluate intraoperative static and dynamic cyclotorsions and postoperative outcomes on astigmatism and high-order aberration in astigmatic or aberrated eyes that underwent laser in situ keratomileusis treatments with advanced cyclotorsion control using the SCHWIND AMARIS.
  
  
  METHODS
  Fifty eyes (30 for aberration neutral and 20 for corneal wavefront) were treated. Treatments were planned with Custom Ablation Manager and ablations were performed using the SCHWIND AMARIS. Laser in situ keratomileusis flaps were cut with an LDV femtosecond laser. Cyclotorsional movements were evaluated for static cyclotorsion component (SCC) for mean and repeatability, and for dynamic cyclotorsion component (DCC) for mean and amplitude. Clinical outcomes were evaluated for predictability, refractive outcome, safety, and wavefront aberration.
  
  
  RESULTS
  Registration rates were 90% for SCC and 98% for DCC. SCC was within ± 5 degrees in 64% of cases. Repeatability of SCC was ± 1 degree in 88% of cases. Mean DCC was within ± 1 degree in 98% of cases, partly compensating for SCC. DCC amplitude was within ± 2 degrees in 84% of cases. At 3-month follow-up, 88% of eyes were within ± 0.50 diopter (D) of astigmatism. Mean defocus was -0.06 ± 0.24 D and astigmatism was 0.27 ± 0.20 D. Best spectacle-corrected visual acuity improved in 42% of eyes versus 2% losing 1 line. In corneal wavefront-customized treatments, coma, trefoil, spherical aberration, and root mean square high-order magnitudes at 6-mm analysis diameter were reduced by -0.04, -0.13, -0.04, and -0.10 μm, respectively.
  
  
  CONCLUSIONS
  Laser in situ keratomileusis with advanced cyclotorsion compensation using the SCHWIND AMARIS is safe and predictable and yields superior visual outcomes. Refractions and high-order aberrations were reduced to subclinical values without applying additional nomograms, showing the excellent performance of the system.
authors.affiliation: SCHWIND AMARIS Grupo de Investigación de Cirugía Refractiva y Calidad de Visión, Instituto de Oftalmobiología Aplicada, University of Valladolid, Valladolid, Spain. samuel.arba.mosquera@eye-tech.net
authors.forename: Samuel
authors.initials: S
authors.lastname: Arba-Mosquera
authors.forename: Maria C
authors.initials: MC
authors.lastname: Arbelaez
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D003319:Corneal Stroma / Q000601:surgery; D057108:Corneal Wavefront Aberration / Q000503:physiopathology / Q000601:surgery*; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011187:Posture; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D013524:Surgical Flaps; D013997:Time Factors; D014102:Torsion Abnormality / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult