Laser in situ keratomileusis using optimized aspheric profiles and cyclotorsion control to treat compound myopic astigmatism with high cylinder.

PURPOSE: To evaluate the visual outcomes after laser in situ keratomileusis (LASIK) surgery to correct primary compound myopic astigmatism with high cylinder performed using a fast-repetition-rate excimer laser platform with optimized aspheric profiles and cyclotorsion control.

SETTING

Vissum Corporation and Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain.

DESIGN

Retrospective consecutive observational nonrandomized noncomparative case series.

METHODS

Eyes with primary compound myopic astigmatism and a cylinder power over 3.00 diopters (D) had uneventful LASIK with femtosecond flap creation and fast-repetition-rate excimer laser ablation with aspheric profiles and cyclotorsion control. Visual, refractive, and aberrometric outcomes were evaluated at the 6-month follow-up. The astigmatic correction was evaluated using the Alpins method and Assort software.

RESULTS

The study enrolled 37 eyes (29 patients; age range 19 to 55 years). The significant reduction in refractive sphere and cylinder 3 months and 6 months postoperatively (P<.01) was associated with improved uncorrected distance visual acuity (P<.01). Eighty-seven percent of eyes had a spherical equivalent within ±0.50 D; 7.5% of eyes were retreated. There was no significant induction of higher-order aberrations (HOAs). The targeted and surgically induced astigmatism magnitudes were 3.23 D and 2.96 D, respectively, and the correction index was 0.91. The safety and efficacy indices were 1.05 and 0.95, respectively.

CONCLUSIONS

Laser in situ keratomileusis for primary compound myopic astigmatism with high cylinder (>3.00 D) performed using a fast-repetition-rate excimer laser with optimized aspheric profiles and cyclotorsion control was safe, effective, and predictable and did not cause significant induction of HOAs.