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S.M. MacRae, M.V. Subbaram; Compensation for Preoperative HOA Improves Myopic Custom LASIK Outcomes . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3623.
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© ARVO (1962-2015); The Authors (2016-present)
To test the efficacy of the Rochester nomogram which integrates preoperative manifest refraction and higher order aberrations (HOA) effects on postoperative sphere and cylinder.
265 myopic eyes (mean spherical equivalent (SE): –4.72±2.02D; HORMS: 0.53±0.14µm) were treated using the Rochester nomogram on the B&L Zyoptix platform (study group). 175 eyes were treated following a pharmacologically dilated wavefront measurement and 90 eyes based on non–pharmacologically dilated wavefront data (natural mesopic pupil ≥6.3 mm). 1–month postoperative visual acuity and refractive error were measured and compared to the same surgeon’s Zyoptix FDA results (112 eyes; control group; mean SE: –3.41±1.44D; HORMS: 0.45±0.18µm @ 6mm aperture).
94% (Rochester nomogram) and 91.5% (FDA control group) attained UCVA ≥20/20 (p<0.05). Mean 1–month SE was –0.07±0.34D (Rochester nomogram, range: ±1D) and +0.26±0.50D (FDA control group, range: –0.75 to +1.50D, p < 0.001). 93.6% (Rochester nomogram) and 72.6% (FDA control group) of eyes were within ±0.5D of target SE (p < 0.01). Hyperopic overcorrections (SE > +0.5D) dropped, nearly 13–fold, from 26.8% (FDA control group) to 2.3% (Rochester nomogram, p<0.001). 93.2% and 94.5% attained UCVA≥20/20, and 91.4% and 96.7% were within ±0.5D of target SE among eyes treated based on pharmacological and non–pharmacological dilation, respectively. Mean 1–month SE was –0.11±0.34 and –0.08±0.23 D for treatments based on pharmacological and non–pharmacological dilation, respectively.
The Rochester nomogram demonstrates that preoperative HOA compensation enhances postoperative outcomes with fewer overcorrections and improves accuracy.
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