Differences between low, medium, and large cyclorotation angles in hyperopic LASIK - visual and refractive results

PurposeTo evaluate the differences in hyperopic laser assisted in situ keratomileusis (LASIK) results between small, medium, and large cyclorotational angle degrees.MethodsThis retrospective study included consecutive patients who underwent hyperopic LASIK between 2012 and 2023 at Care-Vision Laser Centers, Israel. Patients were divided into three groups according to their cyclorotation angle magnitude. A comparison of baseline and intraoperative parameters was performed. Refractive and visual outcomes were assessed, including Efficacy and safety indexes, and an Alpins vector analysis was performed. Multiple linear regression was performed to identify the effect of potential confounders.ResultsOverall, 621 eyes of 428 patients were included. Mean age was 44.5 ± 12.6 years and 52.7% were female. Analysis indicated no significant differences in any of the visual and refractive outcomes including the calculated indexes. Alpins vector analysis showed no significant differences between the groups in any of the vectors either in size or magnitude, nor were there significant differences in the Alpins calculated indicators. Multi-linear regression for potential confounders suggested the preoperative axis had significant confounding association only with a null effect (β < 0.01, p = 0.03) on the Alpins index of success.ConclusionsCyclorotational angle magnitude did not significantly impact visual or refractive outcomes in hyperopic LASIK performed using modern excimer laser systems with cyclorotation correction abilities. These findings suggest limited clinical relevance of cyclorotation degree in LASIK outcomes in this context, with other factors potentially playing a more significant role in surgical planning.