Ray-tracing–guided myopic LASIK: real-world clinical outcomes

Abstract Purpose: To assess effectiveness of individualized ray-trace based laser in situ keratomileusis (ray-trace LASIK) for correction of myopia in everyday clinical practice. Setting: Single site private practice Design: Retrospective nonrandomised unmasked chart review Methods: Consecutive, myopic eyes (range -8.25D sphere; astigmatism 0 to -4.25 D) treated with ray-trace LASIK were included. Patients underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap (Alcon) diagnostic device. The ray-trace based algorithm (InnovEyes algorithm, Alcon) then generated an individualized 3D eye model and calculated a customized LASIK ablation profile. Postoperative visual acuity, refractive error and whole eye higher-order aberrations (HOA) were evaluated over 3 months. Results: The procedure was performed on 400 eyes (200 patients). Mean preoperative manifest refraction spherical equivalent (MRSE) was -3.39±1.58D (OD-3.84±1.63D, OS -3.98±1.75D). At Month 3, UDVA was ≥20/20 in all eyes, ≥20/16 in 89% (OD 90%, OS 89%), ≥20/12 in 51% (54% OD; 47% OS), and 20/10 in 8% (OD 8%; OS 9%) of eyes respectively. UCVA was within 1 line of preoperative CDVA in 98% of eyes (OD 98.5%; OS 98%) and 39% of eyes (OD 38%; OS 39%) gained 1 line improvement. There was a statistically but not clinically significant increase in total HOA (OD 0.06 ±0.133μm; OS 0.057±0.125μm; p<0.001). The spherical aberration decreased (OD-0.047±0.095μm, p<0.001; OS-0.051±0.091μm, p<0.001). Conclusion: Ray-trace LASIK was safe and effective for correction of myopia with and without astigmatism. Approximately, half the eyes achieved ≥20/12.5 UCDVA and 8% achieved 20/10. There was no clinically significant increase in total whole eye HOA.