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Factors Affecting Ray Trace LASIK Data Acquisition in Clinical Practice: Options for Addressing Accommodation.

Akshaya L Thananjeyan1,2, Chandra Bala1

  • 1PersonalEyes, Sydney, NSW, Australia.

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|July 8, 2025
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Summary

Successful data acquisition for InnovEyes guided ray trace LASIK is feasible, with a learning curve observed. Surgeon adjustments or cycloplegic measurements effectively manage accommodation for optimal refractive outcomes.

Keywords:
accommodationhigher order aberrationlaser in situ keratomileusisray trace

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Area of Science:

  • Ophthalmology
  • Refractive Surgery
  • Optometry

Background:

  • Laser-Assisted In Situ Keratomileusis (LASIK) is a common refractive surgery procedure.
  • InnovEyes Sightmap (Wavelight Plus, Alcon) system facilitates ray trace-based LASIK planning.
  • Accurate preoperative data acquisition is crucial for successful LASIK outcomes.

Purpose of the Study:

  • To evaluate factors influencing successful data acquisition for InnovEyes guided ray trace LASIK.
  • To assess the impact of accommodation on wavefront measurements and subsequent refractive outcomes.

Main Methods:

  • Retrospective review of 1283 eyes with myopia and myopic astigmatism undergoing LASIK planning.
  • Preoperative measurements using the InnovEyes Sightmap system.
  • Analysis of scan time, scan count, pupil size, and refractive data (SEQ); subset analysis for accommodation management.

Main Results:

  • Mean scanning time and number of scans per eye decreased over the 18-month study period, indicating an operator learning curve.
  • In cases where wavefront SEQ was more myopic than manifest SEQ, surgeon adjustments to within 0.5D of manifest SEQ resulted in 98% achieving 20/20 UDVA.
  • Treatment using cycloplegic wavefront data in 23 eyes led to 96% achieving 20/20 UDVA.

Conclusions:

  • The InnovEyes Sightmap system is feasible for clinical use in ray trace LASIK, with an identifiable operator learning curve.
  • Accommodation during wavefront measurement can be effectively managed by surgeon adjustment of treatment parameters or by utilizing cycloplegic wavefront data.
  • These management strategies contribute to achieving excellent uncorrected distance visual acuity (UDVA) post-LASIK.