Custom air puff-derived biomechanical variables in a refractive surgery screening setting: Study from 2 centers.

Area of Science:

• Ophthalmology
• Corneal Biomechanics
• Refractive Surgery

Background:

• Laser in situ keratomileusis (LASIK) is a common refractive surgery.
• Patient selection for LASIK is crucial to avoid complications like corneal ectasia.
• Corneal biomechanical properties are increasingly recognized as important factors in LASIK candidacy.

Purpose of the Study:

• To evaluate the predictive capability of air puff-derived biomechanical variables for identifying patients unsuitable for LASIK.
• To determine if specific biomechanical measures correlate with surgeon-perceived LASIK candidacy.

Main Methods:

• Retrospective case series involving two surgeons at two institutions.
• Data from refractive surgery screening examinations were analyzed.
• Ocular Response Analyzer data and three custom biomechanical variables were compared between LASIK candidates and disqualified cases.

Main Results:

• Hysteresis loop area significantly differed between disqualified cases and controls for both surgeons (P < .05).
• Receiver operating characteristic analysis indicated predictive value for concavity minimum and hysteresis loop area.
• Hysteresis loop area showed the highest odds ratio for predicting disqualification (up to 20.00).

Conclusions:

• Hysteresis loop area is a significant predictor of LASIK disqualification across different surgical sites.
• Corneal dynamic response measures may serve as indicators for clinically perceived ectasia risk.
• These biomechanical variables could enhance patient selection for LASIK surgery.