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Wavefront-Guided LASIK Using the VISX CustomVue™ Star S4 Laser System With and Without Iris Registration™: A Retrospective Comparative Study PowerPoint PPT Presentation


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Wavefront-Guided LASIK Using the VISX CustomVue™ Star S4 Laser System With and Without Iris Registration™: A Retrospective Comparative Study. Sonal B. Dave, MD Ladan Espandar, MD Majid Moshirfar, MD John A. Moran Eye Center Salt Lake City, Utah. Purpose.

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Wavefront-Guided LASIK Using the VISX CustomVue™ Star S4 Laser System With and Without Iris Registration™: A Retrospective Comparative Study

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Wavefront-Guided LASIK Using the VISX CustomVue™ Star S4 Laser System With and Without Iris Registration™: A Retrospective Comparative Study

Sonal B. Dave, MD

Ladan Espandar, MD

Majid Moshirfar, MD

John A. Moran Eye Center

Salt Lake City, Utah


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Purpose

To compare visual outcomes after laser in situ

keratomileusis (LASIK) using the VISX Star S4

CustomVue™, with and without Iris

Registration™ (IR) technology.

Is there a difference between Iris Registration™ and non-Iris Registration™ LASIK?


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Methods

  • Retrospective study

  • 239 myopic eyes of 142 patients with or without astigmatism underwent LASIK

  • Primary LASIK treatment with the VISX Star S4 CustomVue™ laser (VISX Incorporated, Santa Clara, CA) with or without Iris RegistrationTM technology

  • 121 eyes with IR

  • 118 without IR

  • Primary outcome measures: uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and manifest refraction

  • Secondary outcome measures: higher-order aberrations (HOA) and vector analysis of residual astigmatism


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UCVA 6 months post LASIK


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6 months post LASIK


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Postoperative month 3 (±0.5 D lines)


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Change in BSCVA (Snellen lines) 6 months postoperatively


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Results

  • At 6 months, the mean values for logMAR UCVA:

    • 0.00 ± 0.09 in the IR group

    • -0.01 ± 0.11 in the non-IR group (p=0.587)

  • UCVA of 20/20 or better:

    • 79% of eyes in the IR group

    • 73% in the non-IR group (p=0.518)

  • Within ±0.5 D of emmetropia:

    • 92% of the eyes in the IR group

    • 90% in the non-IR group (p=0.999)

  • Mean postoperative absolute changes in total root mean square (RMS) higher order aberrations HOA (μm):

    • IR group 0.22

    • non-IR group 0.19 (p=0.6)

  • At 3 months, the mean magnitude of error of surgically induced astigmatism:

    • -0.09 in the IR group

    • -0.04 in the non-IR group (p=0.24)


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Why did IR not have better outcomes?

  • Eyes were marked at the limbus and patients were adjusted accordingly

  • IR was performed prior to lifting of flaps resulting in possible patient movement after iris verification

  • Stromal remodeling and epithelial hyperplasia may mask benefits of IR

  • Other thoughts???


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Conclusions

  • Wavefront-guided LASIK with the VISX Star S4 CustomVue™ laser system, independent of Iris Registration™ status, is effective, safe, and predictable.

  • This study did not find any statistical significance supporting the better achievement of visual acuity, astigmatism correction, or the lesser induction of HOA using Iris Registration™ in comparison to a non-Iris Registration™ system.


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References

Supported in part by an unrestricted grant from Research To Prevent Blindness, Inc., New York, NY, to the Department of Ophthalmology and Visual Sciences, University of Utah

http://joneseyecenters.com/images/content/joneseyecenters/Iris_Registration_Image.jpg

http://www.cullomeyecenter.com/images/content/visxS3_fullview_sm.jpg

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