NIDEK optimized prolate ablation for the treatment of myopia with and without astigmatism.

PURPOSE To report the ocular and corneal higher order aberrations of a pilot trial of optimized prolate ablations for the treatment of myopia. METHODS In this prospective study, patients were treated using optimized prolate ablation or conventional ablation. Five patients underwent bilateral optimized prolate ablation treatment, and nine patients were randomized to receive optimized prolate ablation (OPA group) in one eye and conventional ablation (control group) in the other eye. The mean preoperative manifest refraction spherical equivalent was -4.13+/-1.17 diopters (D) (range: -8.00 to -1.50 D), with a mean cylinder of -0.42+/-0.32 D (range: -1.00 to 0.00 D). Predictability, contrast sensitivity, and corneal and ocular aberrations were analyzed out to 6 months postoperatively. RESULTS Postoperative predictability was similar between the two groups. There was an increase in mesopic contrast sensitivity in the OPA group, and the OPA group had higher mesopic contrast sensitivity postoperatively. At 6 months postoperatively, the root-mean-square (RMS) of the total ocular higher order aberrations was 0.47 microm for the OPA group and 0.75 microm for the control group. Ocular spherical aberration was 0.04 microm for the OPA group and 0.22 microm for the control group. Six-month postoperative RMS of corneal spherical aberration was 0.25 microm for the OPA group and 0.46 microm for the control group. CONCLUSIONS The preliminary outcomes in this study indicate that optimized prolate ablation-treated eyes had less induction of higher order aberration and spherical aberrations postoperatively. Better contrast sensitivity was noted in eyes that underwent optimized prolate ablation treatment compared with preoperatively.