Advertisement

The association between femtosecond laser flap parameters and ocular aberrations after uncomplicated custom myopic LASIK

  • Christopher T. Hood
  • Ronald R. Krueger
  • Steven E. Wilson
Refractive Surgery

Abstract

Background

To investigate the association between femtosecond laser flap parameters, uncorrected distance visual acuity, and higher-order aberrations (HOA) after customized myopic LASIK.

Methods

Retrospective review of the charts of patients who underwent uncomplicated wavefront-guided customized myopic LASIK with flap creation using the femtosecond laser. Patients were stratified by intended flap thickness, and the change in HOA from preoperative to 3 months postoperative was compared. Multivariate linear models were performed to assess the association between calculated flap thickness, intended flap diameter, HOA, and uncorrected visual acuity.

Results

One hundred seventy-one eyes of 171 patients were included. There was no statistically significant difference in the induction of HOA between eyes with thin (90 μm) or thick (100 or 110 μm) intended flaps. In a multivariate model, the level of myopic correction was highly associated with the induction of total HOA, coma, and spherical aberration. There was no correlation between calculated flap thickness, uncorrected visual acuity, or HOAs. Intended flap diameter was not associated with coma or spherical aberration, but larger flap diameter was associated with better uncorrected visual acuity.

Conclusions

Femtosecond laser flap thickness in the range of 90–110 μm was not associated with uncorrected visual acuity or the induction of HOA after uncomplicated customized myopic LASIK. The level of myopic correction was the largest determinant of the induction of HOA.

Keywords

Femtosecond laser Flap thickness Flap diameter Custom LASIK Higher-order aberrations Uncorrected visual acuity IntraLASE 

Notes

Conflicts of interest and source of funding

Dr. Krueger is a consultant for Alcon, Ft. Worth, TX. For the remaining authors, there are no conflicts of interest.

References

  1. 1.
    Miller JM, Anwaruddin R, Straub J, Schwiegerling J (2002) Higher-order aberrations in normal, dilated, intraocular lens, and laser in situ keratomileusis corneas. J Refract Surg 18:S579–S583PubMedGoogle Scholar
  2. 2.
    Moreno-Barriuso E, Lloves JM, Marcos S, Navarro R, Llorente L, Barbero S (2001) Ocular aberrations before and after myopic corneal refractive surgery: LASIK-induced changes measured with laser ray tracing. Invest Ophthalmol Vis Sci 42:1396–1403PubMedGoogle Scholar
  3. 3.
    Mrochen M, Kaemmerer M, Mierdel P, Seiler T (2001) Increased higher-order optical aberrations after laser refractive surgery: a problem of subclinical decentration. J Cataract Refract Surg 27:362–369PubMedCrossRefGoogle Scholar
  4. 4.
    Pesudovs K (2005) Wavefront aberration outcomes of LASIK for high myopia and high hyperopia. J Refract Surg 21:S508–S512PubMedGoogle Scholar
  5. 5.
    Anera RG, Villa C, Jimenez JR, Gutierrez R (2009) Effect of LASIK and contact lens corneal refractive therapy on higher-order aberrations and contrast sensitivity function. J Refract Surg 25:277–284PubMedGoogle Scholar
  6. 6.
    Yamane N, Miyata K, Samejima T, Hiraoka T, Kiuchi T, Okamoto F, Hirohara Y, Mihashi T, Oshika T (2004) Ocular higher-order aberrations and contrast sensitivity after conventional laser in situ keratomileusis. Invest Ophthalmol Vis Sci 45:3986–3990PubMedCrossRefGoogle Scholar
  7. 7.
    Chalita MR, Chavala S, Xu M, Krueger RR (2004) Wavefront analysis in post-LASIK eyes and its correlation with visual symptoms, refraction, and topography. Ophthalmology 111:447–453PubMedCrossRefGoogle Scholar
  8. 8.
    Chalita MR, Xu M, Krueger RR (2003) Correlation of aberrations with visual symptoms using wavefront analysis in eyes after laser in situ keratomileusis. J Refract Surg 19:S682–S686PubMedGoogle Scholar
  9. 9.
    Sharma M, Wachler BS, Chan CC (2007) Higher-order aberrations and relative risk of symptoms after LASIK. J Refract Surg 23:252–256PubMedGoogle Scholar
  10. 10.
    Porter J, MacRae S, Yoon G, Roberts C, Cox IG, Williams DR (2003) Separate effects of the microkeratome incision and laser ablation on the eye's wave aberration. Am J Ophthalmol 136:327–337PubMedCrossRefGoogle Scholar
  11. 11.
    Pallikaris IG, Kymionis GD, Panagopoulou SI, Siganos CS, Theodorakis MA, Pallikaris AI (2002) Induced optical aberrations following formation of a laser in situ keratomileusis flap.[see comment]. J Cataract Refract Surg 28:1737–1741PubMedCrossRefGoogle Scholar
  12. 12.
    Potgieter FJ, Roberts C, Cox IG, Mahmoud AM, Herderick EE, Roetz M, Steenkamp W (2005) Prediction of flap response. J Cataract Refract Surg 31:106–114PubMedCrossRefGoogle Scholar
  13. 13.
    Waheed S, Chalita MR, Xu M, Krueger RR (2005) Flap-induced and laser-induced ocular aberrations in a two-step LASIK procedure. J Refract Surg 21:346–352PubMedGoogle Scholar
  14. 14.
    Guell JL, Velasco F, Roberts C, Sisquella MT, Mahmoud A (2005) Corneal flap thickness and topography changes induced by flap creation during laser in situ keratomileusis. J Cataract Refract Surg 31:115–119PubMedCrossRefGoogle Scholar
  15. 15.
    Kezirian GM, Stonecipher KG (2004) Comparison of the IntraLase femtosecond laser and mechanical keratomes for laser in situ keratomileusis. J Cataract Refract Surg 30:804–811PubMedCrossRefGoogle Scholar
  16. 16.
    Tran DB, Sarayba MA, Bor Z, Garufis C, Duh YJ, Soltes CR, Juhasz T, Kurtz RM (2005) Randomized prospective clinical study comparing induced aberrations with IntraLase and Hansatome flap creation in fellow eyes: potential impact on wavefront-guided laser in situ keratomileusis. J Cataract Refract Surg 31:97–105PubMedCrossRefGoogle Scholar
  17. 17.
    Krueger RR, Dupps WJ Jr (2007) Biomechanical effects of femtosecond and microkeratome-based flap creation: prospective contralateral examination of two patients. J Refract Surg 23:800–807PubMedGoogle Scholar
  18. 18.
    Montes-Mico R, Rodriguez-Galietero A, Alio JL (2007) Femtosecond laser versus mechanical keratome LASIK for myopia. Ophthalmology 114:62–68PubMedCrossRefGoogle Scholar
  19. 19.
    Medeiros FW, Stapleton WM, Hammel J, Krueger RR, Netto MV, Wilson SE (2007) Wavefront analysis comparison of LASIK outcomes with the femtosecond laser and mechanical microkeratomes. J Refract Surg 23:880–887PubMedGoogle Scholar
  20. 20.
    Cheng ZY, He JC, Zhou XT, Chu RY (2008) Effect of flap thickness on higher-order wavefront aberrations induced by LASIK: a bilateral study. J Refract Surg 24:524–529PubMedGoogle Scholar
  21. 21.
    Hosny M, Awadalla MA (2008) Comparison of higher-order aberrations after LASIK using disposable microkeratome 130 and 90 micron heads. Eur J Ophthalmol 18:332–337PubMedGoogle Scholar
  22. 22.
    Moshirfar M, Hatch BB, Chang JC, Kurz CJ, Eugarrios MF, Mifflin MD (2011) Prospective, contralateral comparison of 120-mum and 90-mum LASIK flaps using the IntraLase FS60 femtosecond laser. J Refract Surg 27:251–259PubMedCrossRefGoogle Scholar
  23. 23.
    Subbaram MV, MacRae S, Slade SG, Durrie DS (2006) Customized LASIK treatment for myopia: relationship between preoperative higher-order aberrations and refractive outcome. J Refract Surg 22:746–753PubMedGoogle Scholar
  24. 24.
    Moshirfar M, Schliesser JA, Chang JC, Oberg TJ, Mifflin MD, Townley R, Livingston MK, Kurz CJ (2010) Visual outcomes after wavefront-guided photorefractive keratectomy and wavefront-guided laser in situ keratomileusis: Prospective comparison. J Cataract Refract Surg 36:1336–1343PubMedCrossRefGoogle Scholar
  25. 25.
    Keir NJ, Simpson T, Jones LW, Fonn D (2009) Wavefront-guided LASIK for myopia: effect on visual acuity, contrast sensitivity, and higher-order aberrations. J Refract Surg 25:524–533PubMedGoogle Scholar
  26. 26.
    Moshirfar M, Espandar L, Meyer JJ, Tanner JR, Holz HA (2007) Prospective randomized trial of wavefront-guided laser in situ keratomileusis with the CustomCornea and CustomVue laser systems. J Cataract Refract Surg 33:1727–1733PubMedCrossRefGoogle Scholar
  27. 27.
    Caster AI, Hoff JL, Ruiz R (2005) Conventional vs wavefront-guided LASIK using the LADARVision4000 excimer laser. J Refract Surg 21:S786–S791PubMedGoogle Scholar
  28. 28.
    Schallhorn SC, Farjo AA, Huang D, Boxer Wachler BS, Trattler WB, Tanzer DJ, Majmudar PA, Sugar A (2008) Wavefront-guided LASIK for the correction of primary myopia and astigmatism a report by the American Academy of Ophthalmology. Ophthalmology 115:1249–1261PubMedCrossRefGoogle Scholar
  29. 29.
    Lopez-Miguel A, Maldonado MJ, Belzunce A, Barrio-Barrio J, Coco-Martin MB, Nieto JC (2012) Precision of a commercial Hartmann–Shack aberrometer: limits of total wavefront laser vision correction. Am J Ophthalmol 154(799–807):e795Google Scholar
  30. 30.
    Buhren J, Kohnen T (2006) Factors affecting the change in lower-order and higher-order aberrations after wavefront-guided laser in situ keratomileusis for myopia with the Zyoptix 3.1 system. J Cataract Refract Surg 32:1166–1174PubMedCrossRefGoogle Scholar
  31. 31.
    Dupps WJ Jr, Roberts C (2001) Effect of acute biomechanical changes on corneal curvature after photokeratectomy. J Refract Surg 17:658–669PubMedGoogle Scholar
  32. 32.
    Murakami Y, Manche EE (2011) Comparison of intraoperative subtraction pachymetry and postoperative anterior segment optical coherence tomography of laser in situ keratomileusis flaps. J Cataract Refract SurgGoogle Scholar
  33. 33.
    Bahar I, Levinger S, Kremer I (2007) Wavefront-guided LASIK for myopia with the Technolas 217z: results at 3 years. J Refract Surg 23:586–590, discussion 591PubMedGoogle Scholar
  34. 34.
    Lin JM, Tsai YY (2005) Laser in situ keratomileusis for different degrees of myopia. Acta Ophthalmol Scand 83:40–45PubMedCrossRefGoogle Scholar
  35. 35.
    Brint SF (2005) Higher-order aberrations after LASIK for myopia with Alcon and Wavelight lasers: a prospective randomized trial. J Refract Surg 21:S799–S803PubMedGoogle Scholar
  36. 36.
    Venter J (2005) Wavefront-guided LASIK with the NIDEK NAVEX platform for the correction of myopia and myopic astigmatism with 6-month follow-up. J Refract Surg 21:S640–S645PubMedGoogle Scholar
  37. 37.
    Hersh PS, Steinert RF, Brint SF (2000) Photorefractive keratectomy versus laser in situ keratomileusis: comparison of optical side effects. Summit PRK-LASIK Study Group. Ophthalmology 107:925–933PubMedCrossRefGoogle Scholar
  38. 38.
    Hersh PS, Fry KL, Bishop DS (2003) Incidence and associations of retreatment after LASIK. Ophthalmology 110:748–754PubMedCrossRefGoogle Scholar
  39. 39.
    Hu DJ, Feder RS, Basti S, Fung BB, Rademaker AW, Stewart P, Rosenberg MA (2004) Predictive formula for calculating the probability of LASIK enhancement. J Cataract Refract Surg 30:363–368PubMedCrossRefGoogle Scholar
  40. 40.
    Netto MV, Wilson SE (2004) Flap lift for LASIK retreatment in eyes with myopia. Ophthalmology 111:1362–1367PubMedCrossRefGoogle Scholar
  41. 41.
    Ghanem RC, de la Cruz J, Tobaigy FM, Ang LP, Azar DT (2007) LASIK in the presbyopic age group: safety, efficacy, and predictability in 40- to 69-year-old patients. Ophthalmology 114:1303–1310PubMedCrossRefGoogle Scholar
  42. 42.
    Knox Cartwright NE, Tyrer JR, Marshall J (2011) Age-related differences in the elasticity of the human cornea. Invest Ophthalmol Vis Sci 52:4324–4329PubMedCrossRefGoogle Scholar
  43. 43.
    Elsheikh A, Wang D, Brown M, Rama P, Campanelli M, Pye D (2007) Assessment of corneal biomechanical properties and their variation with age. Curr Eye Res 32:11–19PubMedCrossRefGoogle Scholar
  44. 44.
    Rocha KM, Kagan R, Smith SD, Krueger RR (2009) Thresholds for interface haze formation after thin-flap femtosecond laser in situ keratomileusis for myopia. Am J Ophthalmol 147:966–972, 972 e961PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Christopher T. Hood
    • 1
    • 2
  • Ronald R. Krueger
    • 1
  • Steven E. Wilson
    • 1
  1. 1.Cleveland Clinic Cole Eye InstituteClevelandUSA
  2. 2.University of Michigan W.K. Kellogg Eye CenterAnn ArborUSA

Personalised recommendations