Clinical outcomes of corneal wavefront customized ablation strategies with SCHWIND CAM in LASIK treatments

Purpose: To evaluate the clinical outcomes of aspheric corneal wavefront (CW) ablation profiles in LASIK treatments. Methods: Thirty eyes treated with CW ablation profiles were included after a follow-up of 6 months. In all cases, standard examinations including preoperative and postoperative wavefront analysis with a CW topographer (Optikon Keratron Scout) were performed. Custom Ablation Manager (CAM) software was used to plan corneal wavefront customized aspheric treatments, and the ESIRIS flying spot excimer laser system was used to perform the ablations (both SCHWIND eye-tech-solutions, Kleinhostheim, Germany). Clinical outcomes were evaluated in terms of predictability, refractive outcome, safety, and wavefront aberration. Results: In general, the postoperative uncorrected visual acuity and the best corrected visual acuity improved (p < 0.001). In particular, the trefoil, coma, and spherical aberrations, as well as the total root-mean-square values of higher order aberrations, were significantly reduced (p < 0.05) when the pre-existing aberrations were greater than the repeatability and the biological noise. Conclusions: The study results indicate that the aspheric corneal wavefront customized CAM approach for planning ablation volumes yields visual, optical, and refractive results comparable to those of other wavefront-guided customized techniques for correction of myopia and myopic astigmatism. The CW customized approach shows its strength in cases where abnormal optical systems are expected. Apart from the risk of additional ablation of corneal tissue, systematic wavefront-customized corneal ablation can be considered as a safe and beneficial method.