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Optimized Zernike Terms Selection In Customized Treatments For Laser Corneal Refractive Surgery. 6 months experience in state-of-the-art treatments. Maria C. Arbelaez, MD 1 Samuel Arba Mosquera, MSc 2,3 Camila Vidal, OD 1.
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Optimized Zernike Terms Selection In Customized Treatments For Laser Corneal Refractive Surgery 6 months experience in state-of-the-art treatments Maria C. Arbelaez, MD1 Samuel Arba Mosquera, MSc2,3 Camila Vidal, OD1 1 Muscat Eye Laser Center (Sultanate of Oman)2 Grupo de Investigación en Cirugía Refractiva y Calidad de Visión (IOBA, Spain)3 SCHWIND eye-tech-solutions (Germany)Preceptor: Jesús Merayo2 The authors Arbelaez and Vidal have no proprietary interest in the materials presented herein Samuel Arba Mosquera is employee at SCHWIND eye-tech-solutions Part of a Doctoral Thesis in Sciences of Vision
Arbelaez, MD. and cols Optimized Zernike Terms Selection in Customized Treatments for Laser Corneal Refractive Surgery • Goals: • To evaluate the clinical application of two methods for minimizing the required ablation tissue based upon: • objective minimization of the maximum depth of a customized ablation • objective minimization of the ablation volume of a customized ablation • both based on the Zernike expansion of the wavefront aberration • Materials: • SCHWIND CAM Software Platform(not approved by U.S. Food and Drug Administration) • SCHWIND ESIRIS Excimer Laser(not approved by U.S. Food and Drug Administration) • SCHWIND Ocular Wavefront Analyzer(not approved by U.S. Food and Dug Administration) • SCHWIND Corneal Wavefront Analyzer: • OPTIKON Keratron Scout • Contrast Sensitivity Tester: • Vision Sciences Research CorporationCST 1800 D
Arbelaez, MD. and cols Optimized Zernike Terms Selection in Customized Treatments for Laser Corneal Refractive Surgery • Groups: • 3 groups treated with LASIK technique with 30 eyes each: • Corneal Wavefront group (CW): Full customized correction • Min Depth group (MD): Optimal Zernike terms selection for minimum depth • Min Volume group (MV): Optimal Zernike terms selection for minimum time CWMDMV
Arbelaez, MD. and cols Optimized Zernike Terms Selection in Customized Treatments for Laser Corneal Refractive Surgery
Arbelaez, MD. and cols Refractive Outcomes Very good refractive outcomes from the three groups: > 57% in 0.25 D; 100% in 1.00 D > 90% in 0.50 DEq; 100% in 1.00 DEq Best results for the MV group, but not statistically significant
Arbelaez, MD. and cols Predictability Very high predictability from the three groups. SEq Cyl Best results for the MV group, but not statistically significant
Arbelaez, MD. and cols Stability & Efficacy Very good UCVA postoperative from the three groups > 87% UCVA 20/20 or better Very stable results from the three groups since the first month follow up Results for the MD and MV groups better than for CW group, statistically significant (p < 0.01)
Arbelaez, MD. and cols Safety Between 34% and 47% of the treatments gained at least 1 line of BSCVA No single eye lost even 1 line of BSCVA Between 30% and 40% of the treatments with post-op UCVA were better than pre-op BSCVA Best results for the MV group, but not statistically significant
Arbelaez, MD. and cols Contrast Sensitivity Excellent improvement in postoperative contrast sensitivity for all three groups Best results for the MV group, but not statistically significant
Arbelaez, MD. and cols Comparison MD group saved -4 µm depth in average MV group saved -3 µm depth in average MD group saved -3 s time in average MV group saved -4 s time in average
Arbelaez, MD. and cols Summary MD group saved -4 µm depth in average MV group saved -3 µm depth in average MD group saved -3 s time in average MV group saved -4 s time in average
Arbelaez, MD. and cols Optimized Zernike Terms Selection in Customized Treatments for Laser Corneal Refractive Surgery Conclusions: • The three groups compared here (CW, MD and MV) are Predictable, Safe, Stable and Accurate • The two minimization techniques compared here can be used to reduce the depth and time needed for the ablation • Depth and time were effectively reduced by up to a maximum of 25%, and by 8% in average • The performed ablations reduced in depth and time did not affect negatively the clinical outcomes postoperatively • The two minimization techniques compared here yielded results equivalent to those of the full customization group
Optimized Zernike Terms Selection in Customized Treatments for Laser Corneal Refractive Surgery Conclusions II: What I would choose for minimization Arbelaez, MD. and cols