2015 - 2 Issue

Original article

Comparison of Visual Acuity and Higher-Order Aberrations after Standard and Wavefront-Guided Myopic Femtosecond Lasik

Radek Anderle
Karolina Skorkovská

Full Text links

DOI:

Published in Czech and Slovak Ophtalmology: 2015 - 2

Published on website: 12.01.2015

Keywords: femtosecond LASIK, higher-order aberrations, wavefront-guided, visual accuity.

Summary

Purpose: To analyze and compare visual acuity, refractive outcomes and higher-order aberrations after standard and wavefront-guided Femto-LASIK at 1, 3, and 12 months postoperatively.

Methods: Study of 95 consecutive eyes of myopic patients (-0.5 to -7.0 D), who underwent Femto-LASIK with standard ablation profile (STA) (49 eyes) or wavefront-guided ablation (WFG) (46 eyes) using femtosecond laser LDV Ziemer and excimer laser MEL 80 Zeiss with iris registration. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction and higher-order ocular aberrations (HOAs). HOAs were measured with Hartmann-Shack wavefront aberrometer WASCA, HOAs analyzed at 6 mm pupil, assessed total HOAs root mean square (RMS HOAs) and individual Zernike coefficients.

Results: Preoperatively, there were no significant differences between STA and WFG groups in UDVA, CDVA, manifest refraction or HOAs. As compared with preoperative values, spherical aberration Z(4,0) increased by 0.24 μm in both groups and it is the main increasing factor  of RMS HOAs (0.05 μm in STA group and 0.08 μm in WFG group). Safety and efficacy index is 1.0 in both ablation profiles. Postoperatively, median UDVA and CDVA achieved 1.2. No patient lost line of CDVA at 12 month postoperatively. All patients were within ± 0,5 D of emmetropia at 12 months. Significant differences were not found between STA and WFG in UDVA, CDVA, manifest refraction or HOAs at 1, 3 and 12 month.

Conclusions: Both wavefront-guided and standard Femto-LASIK with LDV and MEL 80 platform have shown very good efficacy and safety. Myopic Femto-LASIK only slightly increases RMS HOAs, especially by induction of spherical aberration. Both methods have equivalent postoperative aberration score one year postoperatively.

References

  1. Auw-Haedrich, C., Staubach, F., Witschel, H.: Optic disk drusen. Surv Ophthalmol, 2002; 47(6): 515–32.
  2. Davis, PL., Jay, WM.: Optic nerve head drusen. Semin Ophthalmol, 2003; 18(4): 222-42.
  3. Friedman, AH., Beckerman, B., Gold, DH., et al.: Drusen of the optic disc. Surv Ophthalmol, 1977; 21(5): 373–90.
  4. Friedman, AH., Gartner, S., Modi, SS.: Drusen of the optic disc. Retrospective study in cadaver eyes. Br J Ophthalmol, 1975; 59(8): 413–21.
  5. Grippo, TM., Rogers, SW., Tsai, JC., et al.: Optic disc drusen. Glaucoma Today, 2012; 10: 19-23.
  6. Kanski, JJ.: Clinical Ophthalmology - A Systematic Approach, 5th ed. Philadelphia: Butterworth Heinemann, 2003.
  7. Katz, BJ., Pomeranz, HD.: Visual field defects and retinal nerve fiber layer defects in eyes with buried optic nerve drusen. Am J Ophthalmol, 2006; 141(2): 248–53.
  8. Kraus, H., et al.: Kompendium očního lékařství. 1. vyd. Praha: Grada Publishing, 1997.
  9. Kuthan, P., Beňová, A., Diblík, P., et al.: Drúzy terče zrakového nervu. (E-Poster). 2014. XXII. výroční sjezd České oftalmologické společnosti, Praha, 19.–21. 6. 2014.
  10. Kurz-Levin, MM., Landau, K.: A com- 2011; 22(2): 124–32.
  11. Lam, BL., Morais, CG. Jr, Pasol, J.: Drusen of the optic disc. Curr Neurol Neurosci Rep, 2008; 8(5): 404–8.
  12. Lee, KM., Woo, SJ., Hwang, JM.: Morphologic characteristics of optic nerve head drusen on spectral-domain optical coherence tomography. Am J Ophthalmol, 2013; 155(6): 1139–47.
  13. Merchant, KY., Su, D., Park, SC., et al.: Enhanced depth imaging optical coherence tomography of optic nerve head drusen. Ophthalmology, 2013; 120(7): 1409-14.
  14. Moreno, M., Vazquez, AM., Dominguez, R., et al.: Severe and acute loss of visual field in a young patient with optic disc drusen. Arch Soc Esp Oftalmol, 2014; 89(8): 324–8.
  15. Morris, RW., Ellerbrock, JM., Hamp, AM., et al.: Advanced visual field loss secondary to optic nerve head drusen: case report and literature review. Optometry, 2009; 80(2): 83–100.
  16. Otradovec, J.: Klinická neurooftalmologie. 1. vyd. Praha: Grada Publishing, 2003.
  17. Pasol, J.: Neuro-ophthalmic disease and optical coherence tomography: glaucoma look-alikes. Curr Opin Ophthalmol,
  18. Sarac, O., Tasci, YY., Gurdal, C., et al.: Differentiation of optic disc edema from optic nerve head drusen with spectral- -domain optical coherence tomography. J Neuroophthalmol, 2012; 32(3): 207–11.
  19. Seitz, R.: The intraocular drusen. Klin Monbl Augenheilkd, 1968; 152(2): 203– 11.
  20. Silverman, AL., Tatham, AJ., Medeiros, FA., et al.: Assessment of optic nerve head drusen using enhanced depth imaging and swept source optical coherence tomography. J Neuroophthalmol, 2014; 34(2): 198–205.
  21. Slotnick, S., Sherman, J.: Disc drusen. Ophthalmology, 2012; 119(3): 652.
  22. Tso, MO.: Pathology and pathogenesis of drusen of the optic nervehead. Ophthalmology, 1981; 88(10): 1066–80.
  23. Vanek, I., Bartošová, J., Bartoš, A.: Neu - rooftalmologie. In: Kuchynka, P., et al.: Oční lékařství. Praha: Grada Publishing, 2007.
  24. Wilkins, JM., Pomeranz, HD.: Visual manifestation of visible and buried optic disc drusen. J Neuroophthalmol, 2004; 24(2): 125–9.
  25. Žiak, P., Jarabáková, K., Koyšová, M.: Drúzová papila – súčasné diagnostické možnosti. Čes a Slov Oftalmol, 2014; 70(1): 30–5.