July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Impact of Ocular Residual Astigmatism on Wavefront Guided LASIK
Author Affiliations & Notes
  • Ying Wang
    Clinical Research, Johnson & Johnson, Santa Ana, California, United States
  • Luis Atiles
    Clinical Research, Johnson & Johnson, Santa Ana, California, United States
  • Stan Bentow
    Clinical Research, Johnson & Johnson, Santa Ana, California, United States
  • Sanjeev Kasthurirangan
    Clinical Research, Johnson & Johnson, Santa Ana, California, United States
  • Footnotes
    Commercial Relationships   Ying Wang, Johnson & Johnson (E); Luis Atiles, Johnson & Johnson (E); Stan Bentow, Johnson & Johnson (E); Sanjeev Kasthurirangan, Johnson & Johnson (E)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5075. doi:
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    • Get Citation

      Ying Wang, Luis Atiles, Stan Bentow, Sanjeev Kasthurirangan; Impact of Ocular Residual Astigmatism on Wavefront Guided LASIK. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5075.

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

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Abstract

Purpose : During wavefront-guided LASIK treatments, total eye refractive astigmatism is corrected at the cornea using excimer laser ablation. The impact of placing all the astigmatic correction at the anterior corneal plane regardless of whether astigmatism arises from anterior cornea or internal sources is explored in this study.

Methods : Re-analysis of data from a previous clinical study for the US-FDA approval of the iDESIGN® wavefront-guided LASIK that included 334 eyes of 170 subjects from 12 clinical sites treated with iDESIGN® aberrometer based wavefront-guided myopic LASIK with the Star S4 IR® laser system. The magnitude of ocular residual astigmatism (ORA) was calculated as the vector difference of preoperative iDESIGN® measured refractive astigmatism and keratometric astigmatism. The ratio of ORA to preoperative iDESIGN® cylinder was calculated to group eyes into high-ORA group (ratio ≥ 1) or low-ORA group (ratio < 1). Postoperative (6-month) refractive outcomes, uncorrected visual acuity and percent cylinder reduction was evaluated as a function of ORA.

Results : Mean magnitude of preoperative ORA was 0.98 D (range: 0.03 D to 7.68 D). Regression analysis showed that, preoperatively, ORA and keratometric astigmatism increased with iDESIGN® cylinder (slopes of 0.31 D and 0.73 D, respectively). About one third of study eyes were in the high-ORA group (n = 113 high-ORA vs. 221 low-ORA). Preoperative refractive astigmatism was lower in the high-ORA group (iDESIGN® cylinder: 0.70 D for low-ORA vs. 2.36 D for high-ORA, p < 0.0001). Outcomes at 6 months compared between low and high ORA group showed that there were no statistically significant differences in manifest spherical equivalent (MRSE, -0.44 D low-ORA vs. -0.50 D high-ORA, p = 0.26), manifest refractive cylinder (MRC, 0.35 D low-ORA vs. 0.29 D high-ORA, p = 0.17) and uncorrected visual acuity (UCVA, -0.06 logMAR low-ORA vs. -0.06 logMAR high-ORA, p = 0.96). Interestingly, eyes in the low-ORA group had mean cylinder reduction of 85% compared to 59% in high-ORA group.

Conclusions : Preoperative ORA and keratometric astigmatism increased with increase in preoperative refractive astigmatism. Postoperative manifest refraction and uncorrected visual acuity were comparable between eyes in high-ORA and low-ORA, although the percent reduction of cylinder was higher in eyes with low-ORA.
© AMO Manufacturing USA, LLC. iDESIGN is a trademark of AMO Manufacturing USA, LLC.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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