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Clinical outcomes of CATz versus OPDCAT
1Clinique Michel Pop, Montreal, Quebec, Canada. mihaipop@cmpop.com
Purpose:
To compare refractive outcomes, wavefront outcomes, and corneal asphericity indices (Q values) for patients treated with wavefront-guided or topography-guided custom ablations using the NIDEK Advanced Vision Excimer Laser System (NAVEX).
Methods:
A total of 196 eyes of 98 patients underwent wavefront-guided or topography-guided LASIK. A contralateral study of 28 eyes of 14 patients who underwent customized aspheric treatment zone (CATz) ablation in one eye and optical path difference customized aspheric treatment (OPDCAT) in the fellow eye comprised one part of the study. The second part of the study was a retrospective review of myopic LASIK using CATz in 84 eyes and LASIK using OPDCAT in 84 eyes. In the CATz-treated eyes, the preoperative mean spherical equivalent refraction was -4.06+/-1.69 diopters (D). In OPDCAT-treated eyes, the preoperative mean spherical equivalent refraction was -3.67+/-2.17 D.
Results:
In the CATz-treated eyes, 95% of eyes achieved > or = 20/20 best spectacle-corrected visual acuity (BSCVA) with 15% gaining lines of BSCVA. In the OPDCAT-treated eyes, 94.5% of eyes achieved > or = 20/20 vision with 4.5% gaining lines of BSCVA. The difference in lines gained between CATz and OPDCAT in the retrospective component was statistically significant (P<.005). OPDCAT-treated eyes showed a statistically significant worsening in OPD root-mean-square (OPD-RMS), higher order wavefront error, and corneal asphericity (P<.005) compared to preoperative in the retrospective portion of the study. In the contralateral arm of the study, OPD-RMS value was significantly higher (P<.005) in the OPDCAT eyes than the fellow CATz-treated eyes. OPDCAT-treated eyes show a larger change in the Strehl ratio compared to the CATz-treated eyes (P<.005).
Conclusions:
The refractive outcomes were excellent and showed no clinically significant difference between CATz and OPDCAT treatments. The higher induction of aberrations with the OPDCAT ablations may be due to the fact that these treatments are based on Zernike polynomials to drive the ablation.
