title: Small optical zones with aspheric profiles in laser refractive surgery for myopia: a surgical outcome and patient satisfaction study.
abstract: OBJECTIVE
  To assess the outcomes of small optical zone (OZ) ablations used in conjunction with large transition zones (TZ) and a highly aspheric treatment profile.
  
  
  METHODS
  Interventional case series of 39 consecutive patients with myopia or myopic astigmatism. Patient data included pre and postoperative refraction and visual acuities, laser treatment settings and pre and postoperative corneal topography as well as questionnaire responses about the use of glasses and the quality of vision postoperatively.
  
  
  RESULTS
  The mean preoperative spherical equivalent was -4.50±2.11 dioptres (D) and the mean OZ and TZ diameters were 4.5±0.5mm and 8.1±0.4mm, respectively. The mean patient age was 40.7±10.4 years. Manifest spherical refraction was within ±0.5D in 87% of patients (±1.0D in 99%) and cylindrical refraction within 0.5D in 79% (≤1.0D in 95%). The need to wear distance glasses postoperatively was associated with dissatisfaction with the quality of daytime vision (p=0.05) and unhappiness with night vision was associated with symptoms of halos (p=0.03) and starbursts (p=0.02). The proportion of patients reporting symptoms of dysphotopsias included: ghosting 0%; glare 2%; halos 10%; and starbursts 15%. There was a significant difference in the measured mean effective OZ diameter (4.8±0.3mm) compared to the mean programmed OZ (4.5±0.5mm, p=0.00).
  
  
  CONCLUSIONS
  Small ablation zones, when used in conjunction with a large diameter TZ, do not lead to a greater incidence of unwanted visual phenomena over that reported by many studies with larger OZs.
authors.affiliation: University of Ulster, School of Biomedical Sciences, Coleraine, UK.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Woodcock
authors.forename: Sunil
authors.initials: S
authors.lastname: Shah
authors.forename: Niraj
authors.initials: N
authors.lastname: Mandal
authors.forename: Stefan
authors.initials: S
authors.lastname: Pieger
authors.forename: Claire
authors.initials: C
authors.lastname: Grills
authors.forename: Tara C B
authors.initials: TC
authors.lastname: Moore
mesh_terms: D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D048988:Corneal Surgery, Laser / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D017060:Patient Satisfaction; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
keywords: LASEK; LASIK; Optical aberrations; Refractive Surgery