Ray tracing-guided LASIK for high myopia and astigmatism: Initial clinical outcomes

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OBJECTIVE: To evaluate visual acuity, refractive outcomes and ocular higher order aberrations (HOAs) following ray tracing-guided laser-assisted in situ keratomileusis (LASIK) for high myopia and astigmatism. METHODS: This retrospective study enrolled 77 eyes in 42 patients with high myopia and astigmatism undergoing ray tracing-guided LASIK. InnvoEyes Sightmap was used for ocular wavefront aberrometry, tomography and biometry assessment. Visual acuity, refractive error and ocular HOAs were evaluated preoperatively and 3 months postoperatively. RESULTS: Preoperative manifest refraction spherical equivalent (MRSE) was -7.52 ± 0.86 D (sphere:6.87 ± 1.02 D; cylinder:1.29 ± 0.82 D). At 3 months, 100 % of eyes achieved uncorrected distance visual acuity (UDVA) ≥ 20/20 with no loss of CDVA. Refractive outcomes showed MRSE within ± 0.50 D in 97 % of eyes and astigmatism within ± 0.25 D in 83 % of eyes. The correction index demonstrated high accuracy (arithmetic: 1.09; geometric: 1.07) with minimal difference vector (0.04 D@99°). While ocular total HOA increased from 0.209 ± 0.080 µm to 0.330 ± 0.108 (p < 0.001), spherical aberration maintained comparable values (0.034 ± 0.067 µm vs 0.038 ± 0.086 µm, p = 0.700). CONCLUSIONS: Ray tracing-guided LASIK demonstrated favorable safety, efficacy and predictability for high myopia and astigmatism in this study. Notably, spherical aberration maintained its values after the procedure, suggesting the potential of ray tracing-guided LASIK to optimize visual acuity and refractive outcomes in the correction of high myopia.

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