Clinical Outcomes and Changes in Higher-Order Aberrations Following Ray-Tracing-Guided LASIK: A Retrospective Study

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Laser-assisted in situ keratomileusis (LASIK) is a common refractive surgery.
• Optimizing LASIK outcomes, particularly for higher-order aberrations (HOAs), remains an area of research.
• Ray-tracing technology offers precise aberrometry for personalized treatment planning.

Purpose of the Study:

• To validate visual, refractive, and HOA outcomes of a simplified ray-tracing-guided LASIK adjustment strategy.
• To assess the efficacy of this strategy in a large, real-world patient cohort.
• To analyze changes in specific HOAs like spherical aberration, coma, and trefoil post-LASIK.

Main Methods:

• Retrospective, single-arm study of 117 patients (234 eyes) undergoing ray-tracing-guided LASIK.
• Preoperative and 3-month postoperative assessments included uncorrected distance visual acuity (UDVA), manifest refraction, and HOAs via iTrace aberrometer.
• Vector analysis and multiple linear regression were used to evaluate outcomes and associations.

Main Results:

• All patients achieved postoperative UDVA of 20/20 or better, with 91.0% achieving 20/16 or better.
• Astigmatism correction accuracy was excellent. No significant changes in total HOAs, spherical aberration, or coma were observed.
• A significant postoperative decrease in trefoil aberration was noted, though higher levels were associated with worse UDVA.

Conclusions:

• The simplified ray-tracing-guided LASIK adjustment strategy provides reliable refractive results.
• This approach leads to a beneficial decrease in trefoil aberration.
• The strategy demonstrates potential for effective management of visual and refractive outcomes in LASIK.