Mutual comparative analysis: a new topography-guided custom ablation protocol referencing subjective refraction to...

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Topography

Background:

• Existing topography-guided custom ablation treatment (T-CAT) algorithms have limitations.
• Ametropia correction requires precise planning methods.
• Integrating multiple data sources can enhance T-CAT accuracy.

Purpose of the Study:

• To evaluate a novel mutual comparative analysis (MCA) for T-CAT.
• To assess MCA's efficacy in correcting ametropia using manifest refraction, corneal topography, and subjective perception.
• To demonstrate MCA's potential as an improved T-CAT planning tool.

Main Methods:

• Retrospective review of 79 patients (121 eyes) with significant preoperative astigmatism differences between manifest refraction and corneal topography.
• T-CAT planning was performed using the novel MCA method.
• Patient follow-up was conducted for at least 6 months postoperatively.

Main Results:

• Postoperative spherical equivalent refraction averaged 0.04 D and cylinder averaged -0.27 D.
• Efficacy and safety indices were 1.10 and 1.15, respectively.
• 91% of eyes achieved residual astigmatism ≤0.5 D, with 61% within ±5° angle of error.

Conclusions:

• The mutual comparative analysis (MCA) demonstrated safety, efficacy, accuracy, predictability, and stability in T-CAT.
• MCA can be utilized as a complementary and feasible method for planning topography-guided custom ablation treatment.
• This approach shows promise for enhancing refractive surgery outcomes.