title: Laser-assisted in situ keratomileusis in high mixed astigmatism with optimized, fast-repetition and cyclotorsion control excimer laser.
abstract: OBJECTIVE
  To evaluate the visual refractive and aberrometric outcomes of laser-assisted in situ keratomileusis (LASIK) surgery for the correction of high mixed astigmatism using a new-generation excimer laser and optimized aspherical profiles.
  
  
  METHODS
  Retrospective interventional case series.
  
  
  METHODS
  Fifty-two eyes of 36 patients (21-53 years) with primary mixed astigmatism over 3.0 diopters (D) were included. All cases underwent LASIK surgery using the sixth-generation excimer laser Amaris with cyclotorsion control and a femtosecond platform for flap creation. Visual, refractive, corneal topographic, and aberrometric outcomes were evaluated during a 3-month follow-up. Refractive astigmatic changes were analyzed by Alpins method.
  
  
  RESULTS
  A significant reduction of refractive sphere and cylinder was observed 3 months postoperatively (P = .001), with an associated improvement of uncorrected distance visual acuity (P = .001). Best-corrected distance visual acuity (CDVA) remained unchanged in 31 eyes (59.6%), while 3 eyes (5.76%) lost 2 lines of CDVA. Fourteen eyes (26.9%) had spherical equivalent (SE) within ±0.5 D of emmetropia and 34 (65.3%) had SE within ±1.0 D of emmetropia. No significant difference was observed when comparing surgically induced and target astigmatism. A significant induction of higher-order aberration attributable to increase of spherical aberration was found (P = .003). Seven eyes (13.4%) required retreatment.
  
  
  CONCLUSIONS
  LASIK for primary high mixed astigmatism using optimized aspherical profiles and a fast-repetition-rate excimer laser with cyclotorsion control is a safe, effective, and predictable procedure. Induction of higher-order aberrations is still present in the correction of the refraction error of the magnitude included in this study.
authors: Instituto Oftalmológico de Alicante, Vissum Corporation, Alicante, Spain. jlalio@vissum.com
authors: Jorge L
authors: JL
authors: Alio
authors: Ketevan
authors: K
authors: Pachkoria
authors: Amr
authors: A
authors: El Aswad
authors: Ana Belen
authors: AB
authors: Plaza-Puche
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012029:Refraction, Ocular; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult