Elliott H Myrowitz1, Roy S Chuck. 1. The Wilmer Eye Institute, The Johns Hopkins School of Medicine, Baltimore, Maryland 21093, USA.
Abstract
PURPOSE OF REVIEW: Optimized aspherical as well as custom wavefront-guided treatments attempt to reduce the induction of visually disturbing aberrations than can occur with conventional spherocylindrical corneal ablation. This review highlights a comparison of the advances and limitations of the two treatments. RECENT FINDINGS: Optimized aspherical as well as wavefront-guided corneal excimer laser treatments have continued to improve in outcomes compared with conventional treatments. Wavefront-guided as well as wavefront-optimized treatments yield high predictability, efficacy, and safety. Equally good vision has been obtained as measured by snellen acuity, patient questionnaires, and total residual higher-order aberrations. Wavefront-guided treatments did have better results in spherical aberration, coma as well as contrast sensitivity outcomes. Surgeons who have easy access to both technologies suggest using wavefront-optimized treatments in 67-88% of patients and reserve wavefront-guided treatments for those who have above average higher-order aberrations. However, even with individually adjusted aspheric, 'Q' values, optimized ablations still increased higher-order aberrations and wavefront-guided treatments also did not achieve the elimination of residual higher-order aberrations. SUMMARY: Optimized aspheric corneal ablations that attempt to avoid reducing the prolate eccentricity of the average cornea as well as wavefront-guided treatments that attempt to reduce the individual whole-eye aberrations have continued to improve visual outcomes compared with conventional treatments.
PURPOSE OF REVIEW: Optimized aspherical as well as custom wavefront-guided treatments attempt to reduce the induction of visually disturbing aberrations than can occur with conventional spherocylindrical corneal ablation. This review highlights a comparison of the advances and limitations of the two treatments. RECENT FINDINGS: Optimized aspherical as well as wavefront-guided corneal excimer laser treatments have continued to improve in outcomes compared with conventional treatments. Wavefront-guided as well as wavefront-optimized treatments yield high predictability, efficacy, and safety. Equally good vision has been obtained as measured by snellen acuity, patient questionnaires, and total residual higher-order aberrations. Wavefront-guided treatments did have better results in spherical aberration, coma as well as contrast sensitivity outcomes. Surgeons who have easy access to both technologies suggest using wavefront-optimized treatments in 67-88% of patients and reserve wavefront-guided treatments for those who have above average higher-order aberrations. However, even with individually adjusted aspheric, 'Q' values, optimized ablations still increased higher-order aberrations and wavefront-guided treatments also did not achieve the elimination of residual higher-order aberrations. SUMMARY: Optimized aspheric corneal ablations that attempt to avoid reducing the prolate eccentricity of the average cornea as well as wavefront-guided treatments that attempt to reduce the individual whole-eye aberrations have continued to improve visual outcomes compared with conventional treatments.
Authors: Marcus Ang; Damien Gatinel; Dan Z Reinstein; Erik Mertens; Jorge L Alió Del Barrio; Jorge L Alió Journal: Eye (Lond) Date: 2020-07-24 Impact factor: 3.775
Authors: Khaled M Hamam; Mohamed I Gbreel; Randa Elsheikh; Amira Y Benmelouka; Yassamine Ouerdane; Amr K Hassan; Aboalmagd Hamdallah; Ahmed B Elsnhory; Anas Z Nourelden; Ahmed T Masoud; Asmaa A Ali; Khaled M Ragab; Ahmed M Ibrahim Journal: Indian J Ophthalmol Date: 2020-12 Impact factor: 1.848