May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Corneal epithelial healing and surgically–induced aberrations after excimer laser correction
Author Affiliations & Notes
  • M. Tang
    Biomedical Engineering, Ohio State University, Columbus, OH
    Biomedical Engineering,
    Cleveland Clinic Foundation, Cleveland, OH
  • R. Shekhar
    Biomedical Engineering,
    Cleveland Clinic Foundation, Cleveland, OH
  • D. Huang
    Biomedical Engineering, Ohio State University, Columbus, OH
    Cole Eye Institute,
    Cleveland Clinic Foundation, Cleveland, OH
  • Footnotes
    Commercial Relationships  M. Tang, None; R. Shekhar, None; D. Huang, None.
  • Footnotes
    Support  Whitaker Foundation grant RG 99–0302
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 2828. doi:
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      M. Tang, R. Shekhar, D. Huang; Corneal epithelial healing and surgically–induced aberrations after excimer laser correction . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2828.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To predict wavefront aberrations associated with epithelial healing after laser in–situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) and develop advance healing adjusted ablation (AHAA) patterns to minimize these aberrations. Methods: Simulation of laser correction of combined myopia, astigmatism, higher order aberrations were performed in a computer. Six–mm optical zone diameter and variable transition zones were used. Post–surgical deviations from intended correction are calculated based on a previously published mathematical model of the smoothing action of epithelial healing. A constrained iterative deconvolution technique was used to design AHAA patterns. Results: The simulated corrections produced complex patterns of secondary aberrations and only the dominant terms are summarized here. Correction of –6 D myopia produced undercorrection of myopia, oblate spherical aberration (S.A., 1.0 micron Z40). The addition of 3 D astigmatism induced tetrafoil (0.5 micron Z42). The additional correction of SA induced myopic/hyperopic shift depending on if the SA is prolate or oblate. The additional correction of coma induced pentafoil. We were able to design AHAA patterns to exactly cancel the healing induced aberration. Conclusions: Our model predicts that laser ablation to correct myopia and astigmatism predictably induce un–intended secondary aberrations, in agreement with published clinical results. Wavefront–guided correction of aberrations also induces significant un–intended deviations. We developed an AHAA algorithm that can theoretically compensate for these secondary deviations and improve the outcome of both spherocylindrical and wavefront–guided laser corrections.

Keywords: refractive surgery: optical quality 
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