Outcomes after topography-based LASIK and LASEK with the wavelight oculyzer and topolyzer platforms

To explore the efficacy, safety, and predictability of topography-guided laser epithelial keratomileusis (LASEK) and LASIK treatments using the ALLEGRO Oculyzer (rotating Scheimpflug image-based) as compared to the ALLEGRO Topolyzer (Placido disk-based) platform (WaveLight AG).

In this retrospective, non-comparative case series, 72 eyes were treated using Oculyzer data and 71 eyes were treated using Topolyzer data. Seventy-nine men and 64 women ranging in age from 21 to 63 years were included in the study. The 6-month postoperative uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) of patients were compared to the preoperative values. The data analysis was stratified based on the preoperative refractions, separating patients into three categories: myopes, hyperopes, and mixed astigmatics.

Of the preoperative myopes in the Oculyzer group, 76% remained the same, 5% lost 1 line, 14% gained 1 line, and 5% gained 2 lines of visual acuity at 6 months. In the Topolyzer group, 69% remained the same, 25% gained 1 line, and 6% gained 2 lines of BSCVA. Using the Oculzyer, 95% of myopes, 80% of hyperopes, and 60% of patients with mixed astigmatism were within 10.50 diopters (D) of target refraction. Using the Topolyzer, 88% of myopes, 78% of hyperopes, and 50% of patients with mixed astigmatism were within +/- 0.50 D of target. The outcomes of the preoperative hyperopes and patients with mixed astigmatism are similarly reported. The difference in outcomes between the Oculyzer and Topolyzer cohorts in the myopes and patients with mixed astigmatism was not statistically significant. In the hyperopes, patients treated with the Oculyzer had superior UCVA to those treated with the Topolyzer platform.

This case series demonstrates that the Oculyzer and Topolyzer are both effective tools in topography-guided corneal excimer laser surgery. In myopes and patients with mixed astigmatism, both systems were comparable in efficacy and safety. In the hyperopes, the resultant UCVA in the Oculyzer cohort was slightly superior.