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

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.