Fitting-Shape-based Strategy for Topography-guided LASIK: A Prospective Study

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Topography-guided LASIK (TGL) aims to improve visual outcomes by customizing ablation profiles.
• Software strategies play a crucial role in optimizing TGL outcomes.
• Comparing different software algorithms is essential for advancing refractive surgery techniques.

Purpose of the Study:

• To compare the visual acuity and refractive results of TGL using two distinct software strategies.
• To evaluate the efficacy of a fitting-shape-based refractive compensated strategy against the Phorcides software algorithm.

Main Methods:

• A randomized study involving patients undergoing TGL.
• Patients were assigned to either the Zhang & Zheng Auto-compensate Refraction (ZZ AR) group or the Phorcides group.
• Visual acuity and refractive outcomes were assessed at a 6-month follow-up.

Main Results:

• The ZZ AR group demonstrated significantly lower median absolute residual cylindrical refraction (0.35 D vs. 0.47 D, P < .001).
• A higher percentage of ZZ AR patients achieved residual cylindrical power within 0.25 D (29.49% vs. 13.61%, P = .001).
• The ZZ AR group also showed a significantly higher percentage of patients with uncorrected visual acuity better than 20/16 (P = .03).

Conclusions:

• The fitting-shape-based refractive compensated strategy (ZZ AR) is more effective than the Phorcides software strategy for TGL.
• ZZ AR optimizes visual acuity and astigmatic refraction outcomes post-LASIK.
• This study supports the use of advanced fitting-shape-based algorithms for personalized refractive surgery.