Corneal wavefront-guided LASIK retreatments for correction of highly aberrated corneas following refractive surgery.

摘要

PURPOSE: To investigate the safety and efficacy of customized corneal wavefront-guided retreatment in symptomatic patients with highly aberrated corneas following LASIK. METHODS: This prospective study included 75 eyes of 59 patients with significant visual symptoms who underwent LASIK for the correction of residual refractive error. Ablation profiles were calculated using CSO corneal topography and ESIRIS/Schwind laser platform. Eyes were divided into two groups: those with significant night vision symptoms (37 eyes; night symptoms group) and those with decentration, irregular ablation profile, and flap complications (38 eyes; corneal complications group). Corneal topography and aberrations, visual acuity, point spread function (PSF), refractive outcome, and subjective symptoms were evaluated preoperatively, and 1, 3, and 6 months postoperatively. RESULTS: Mean uncorrected visual acuity was 20/32 preoperatively and 20/25 at 6 months postoperatively in the night symptoms group and 20/40 preoperatively and 20/30 at 6 months postoperatively in the corneal complications group. Mean best spectacle-corrected visual acuity was 20/25 both preoperatively and 6 months postoperatively in both groups (t test, P = .219 and P = .149 for the night symptoms and corneal complications groups, respectively). Safety index was 1.1 in both groups, and efficacy index was 0.93 and 0.92, respectively. Statistically significant improvement of total corneal higher order aberrations, tilt, and improvement of spherical aberrations and coma were observed, with corresponding improvement of PSF. CONCLUSIONS: Corneal wavefront-guided LASIK retreatment with CSO topography, ORK-W software, and ESIRIS/Schwind laser platform is safe and effective for treating symptomatic patients affected by corneal higher order aberrations or corneal irregularities following LASIK surgery.