Abstract
PURPOSE:
To report the outcomes of LASIK for mixed cylinder using the Triple-A ablation profile with the MEL 90 excimer laser (Carl Zeiss Meditec, Jena, Germany).
METHODS:
This was a retrospective analysis of all eyes treated by LASIK for mixed cylinder using the Triple-A ablation profile with the MEL 90 laser between July 2013 and October 2016. Patients were observed for 1 year after surgery. Standard outcomes analysis and vector analysis by the Alpins method were performed.
RESULTS:
The database review identified 105 eyes (82 patients) treated by LASIK for mixed cylinder using the MEL 90 laser. Mean age was 40 ± 11 years (range: 18 to 65 years). Mean attempted spherical equivalent was +0.30 ± 0.90 diopters (D) (range: −2.30 to +1.75 D). Mean cylinder was −2.93 ± 1.47 D (range: −0.75 to −7.00 D). Preoperative corrected distance visual acuity (CDVA) was 20/20 or better in 81% of eyes. Postoperative uncorrected distance visual acuity was 20/20 or better in 69% and 20/25 or better in 86% of eyes. Mean postoperative spherical equivalent relative to the intended target was −0.21 ± 0.38 D (range: −1.25 to +1.13 D), with 83% within ±0.50 D. Mean postoperative cylinder was −0.57 ± 0.41 D (range: 0.00 to −1.75 D). Geometric mean was 1.12 for the correction index and 0.25 for the index of success. For angle of error, the arithmetic mean was −0.6° ± 4.2° (range: −13.5° to 9.5°) and the absolute mean was 2.9° ± 3.0° (range: 0.0° to 13.5°). There was loss of one line of CDVA in 3% of eyes and no eyes lost two or more lines CDVA. There was a small increase in contrast sensitivity after surgery at 3, 6, 12, and 18 cycles per degree (P < .05).
CONCLUSIONS:
One-year outcomes of LASIK using the MEL 90 laser for mixed cylinder up to −7.00 D demonstrated excellent efficacy, safety, and predictability. Vector analysis found a 12% overcorrection in magnitude of refractive cylinder. Given the high accuracy for angle of error, a nomogram could be applied to reduce the over-correction and further improve the uncorrected distance visual acuity outcomes.
[J Refract Surg. 2018;34(10):672–680.]
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