Preoperative%20Distribution%20of%20Higher%20Order%20Aberrations%20in%20Patients%20Undergoing%20LASIK

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Preoperative Distribution of Higher Order
Aberrations in Patients Undergoing LASIK

• Perry S. Binder, MS MD

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Financial Disclosure

• Abbott Medical Optics A, B, C, E
• Allergan, Inc. A, B, D,E
• Acufocus, Inc. A, D, E
• UV X A, D
• Ophthonix, Inc. A
• Outocmes Analysis Software P
• RXVP - P

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Introduction

• It has been suggested that Wavefront-guided
  treatments be considered only if the magnitude of
  preoperative root-mean-square (RMS) higher order
  aberrations is gt0.30 microns.
• The conclusions were based on the use of
  Tscherring aberrometry in fewer than 300 eyes

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Purpose

• To determine the incidence and distribution of
  higher order aberrations (HOA) in patients
  undergoing LASIK and to compare the HOA root mean
  square (RMS) in patients who underwent wavefront
  aberrometry with either the CustomVue Wavescan
  (AMO) or the Allegretto LadarWave (Alcon)
  aberrometers.

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Methods

• Retrospective analysis of a clinical database
  (Outcomes Analysis Software v 4.1, San Diego, CA)
  of 3,568 consecutive eyes undergoing LASIK
  performed by a single surgeon.
• The CustomVue Wavescan aberrometer was used on
  1,365 eyes
• The Allergretto LadarWave was used on 2,194 eyes.
• All aberrometry was performed by one of several
  technicians
• A previous comparison of these aberrometers on a
  small number of eyes and plastics showed them to
  be equivalent (Warden et. al. J Refr. Surg.
  24188-196, 2008)

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HOA RMS Eyes with more than 0.3 µm Total on Both
Aberrometers
Pre-op
Post-op
Preoperatively, 46.8 of eyes (1,670/3,568) had
HOA RMS of 0.3 µm or greater Irrespective of
pupil diameter
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HOA RMS Pre-op by Aberrometer
Custom Vue
Ladar Wave

• Preoperatively, mean HOA RMS was significantly
  greater in the LadarWave group
• than in the CustomVue WaveScan group.
• This difference was statistically significant
  (Plt.001).

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Significantly Better Preop Defocus and SA with
CustomVue WaveScan



P.0299 Plt.001
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Significantly Better Postop Defocus, Coma and SA
with CustomVue WaveScan



Plt.001
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HOA RMS Correlation Between Aberrometer and RMSm
No Difference
Pre-op
Post-op
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Conclusions

• Using Hartman Shack aberrometers, many eyes
  (gt40) have a preoperative HOA RMS gt 0.3 um for
  mesopic pupils gt6.00 mm
• Both pre- and post-op, CustomVue Wavescan
  measured significantly less RMS HOA (Plt.001) than
  the Allegretto LadarWave in myopic eyes, but both
  had gt 45 of eyes with HOA RMS gt0.3 um.
• Both pre- and post-op, defocus and spherical
  aberration were less with CustomVue Wavescan than
  with the Allegretto LadarWave aberrometer, (Plt.03
  for defocus, Plt.001 for SA).