title: Stability of therapeutic retreatment of corneal wavefront customized ablation with the SCHWIND CAM: 4-year data.
abstract: OBJECTIVE
  To evaluate the long-term outcomes of aspheric corneal wavefront ablation profiles for excimer laser retreatment.
  
  
  METHODS
  Eighteen eyes that had previously undergone LASIK or photorefractive keratectomy (PRK) were retreated with LASIK using the corneal wavefront ablation profile. Custom Ablation Manager (SCHWIND eye-tech-solutions, Kleinostheim, Germany) software and the ESIRIS flying spot excimer laser system (SCHWIND) were used to perform the ablations. Refractive outcomes and wavefront data are reported up to 4 years after retreatment. Pre- and postoperative data were compared with Student t tests and (multivariate) correlation tests. P<.05 was considered statistically significant. A bilinear correlation of various postoperative wavefront aberrations versus planned correction and preoperative aberration was performed.
  
  
  RESULTS
  Mean manifest refraction spherical equivalent (MRSE) before retreatment was -0.38±1.85 diopters (D) and -0.09±0.22 D at 6 months and -0.10±0.38 D at 4 years postoperatively. The reduction in MRSE was statistically significant at both postoperative time points (P<.005). Postoperative aberrations were statistically lower (spherical aberration P<.05; coma P<.005; root-mean-square higher order aberration P<.0001) at 4 years postoperatively. Distribution of the postoperative uncorrected distance visual acuity (P<.0001) and corrected distance visual acuity (P<.01) were statistically better than preoperative values.
  
  
  CONCLUSIONS
  Aspheric corneal wavefront customization with the ESIRIS yields visual, optical, and refractive results comparable to those of other wavefront-guided customized techniques for the correction of myopia and myopic astigmatism. The corneal wavefront customized approach shows its strength in cases where abnormal optical systems are expected. Systematic wavefront customized corneal ablation appears safe and efficacious for retreatment cases.
authors.affiliation: Emmetropia Mediterranean Eye Clinic, Crete, Greece.
authors.forename: Ioannis M
authors.initials: IM
authors.lastname: Aslanides
authors.forename: Sai
authors.initials: S
authors.lastname: Kolli
authors.forename: Sara
authors.initials: S
authors.lastname: Padroni
authors.forename: Sara
authors.initials: S
authors.lastname: Padron
authors.forename: Samuel
authors.initials: S
authors.lastname: Arba Mosquera
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008875:Middle Aged; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology