Wavefront- and topography-guided ablation in myopic eyes using Zyoptix

Purpose: To evaluate the results of wavefront- and topography-guided ablation in myopic eyes using Zyoptix (Bausch & Lomb). Setting: Eye Research Center and Dr. Agarwal's Eye Hospital, Chennai, India. Methods: This observational case study comprised 150 eyes with myopia and compound myopic astigmatism. Preoperatively, the patients had corneal topography with Orbscan® IIz (Bausch & Lomb) and wavefront analysis with the Zywave® aberrometer (Bausch & Lomb) in addition to the routine workup before laser in situ keratomileusis (LASIK). The results were assimilated using Zylink® software (Bausch & Lomb), and a customized treatment plan was formulated. Laser in situ keratomileusis was performed with the Technolas® 217 system (Bausch & Lomb). The patients were followed for at least 6 months. Results: The mean preoperative best corrected visual acuity (BCVA) (in decimal equivalent) was 0.83 (20/25) ± 0.18 (SD) (range 0.33 to 1.00) and the mean postoperative (6 months) BCVA, 1.00 (20/20) ± 0.23 (range 0.33 to 1.50). Three eyes (2%) lost 2 or more lines of best spectacle-corrected visual acuity. The safety index was 1.20. The mean preoperative uncorrected visual acuity (UCVA) was 0.06 (20/350) ± 0.02 (range 0.01 to 0.50) and the mean postoperative UCVA, 0.88 (20/25) ± 0.36 (range 0.08 to 1.50). The efficacy index was 14.66. The mean preoperative spherical equivalent (SE) was −5.25 ± 1.68 diopters (D) (range −0.87 to −15.00 D) and the mean postoperative SE (6 months), −0.36 ± 0.931 D (range −4.25 to +1.25 D). At 6 months, the UCVA was 1.00 (6/6) or better in 105 eyes (69.93%) and 0.5 (6/12) or better in 126 eyes (83.91%). The postoperative aberrations were decreased compared with the preoperative aberrations. One eye (0.66%) had a free cap during LASIK with subsequent loss of 2 lines of BCVA and induced higher-order aberrations (HOAs). Nine patients (11.2%) complained of halos at night. Conclusions: Wavefront- and topography-guided LASIK leads to improve visual performance by decreasing HOAs. Scotopic visual complaints may be reduced with this method.