Initial Outcomes with Customized Myopic LASIK, Guided by Automated Ray Tracing Optimization: A Novel Technique

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Laser-assisted in situ keratomileusis (LASIK) is a common refractive surgery for myopia.
• Customization of excimer laser ablation profiles is crucial for optimizing visual outcomes.
• Current methods may not fully account for individual ocular aberrations.

Purpose of the Study:

• To evaluate the safety and efficacy of a novel automated ray tracing optimization for customizing excimer ablation in myopic LASIK.
• To assess the impact of this AI-driven platform on visual acuity and refractive outcomes.

Main Methods:

• A consecutive case series of 25 patients (50 eyes) undergoing femtosecond-laser-assisted myopic LASIK.
• Utilized a novel artificial-intelligence platform for ablation profile calculation based on a customized eye model and interferometry data.
• Employed ray tracing on wavefront and Scheimpflug tomography measurements for low- and high-order aberration calculation.
• Evaluated visual acuity, refractive error, keratometry, topography, high-order aberrations, and contrast sensitivity over six months.

Main Results:

• Mean refractive error improved from -5.06 D to -0.11 D; refractive astigmatism improved from -1.07 D to -0.15 D.
• Topographic astigmatism improved from -1.65 D to -0.26 D.
• 65% of eyes gained one line of vision, and 38% gained two lines; contrast sensitivity improved post-operatively.

Conclusions:

• The novel excimer laser customization using ray tracing optimization demonstrated safe and effective preliminary outcomes for myopic LASIK.
• This approach, integrating multiple diagnostics and a customized eye model, has the potential for improved and more predictable visual results.
• The use of total eye aberration data and ray tracing refraction calculation may enhance refractive surgery outcomes.