Advances for refractive laser surgery aim to boost outcomes

Take-home message: Improvements to refractive laser surgery will continue to make procedures even more precise and accurate.

 Reviewed by Michael Mrochen, PhD

Zurich-Refractive laser platforms provide outstanding results, have reliable technology with excellent predictability and outcomes, and provide a broad range of applications. Better diagnostic imaging is possible with optical coherence tomography and Scheimpflug technology, and the advances of femtosecond lasers are moving into cataract surgery, said Michael Mrochen, PhD.

“An element connecting all these components is treatment planning,” said Dr. Mrochen, founder of IROC Science, Zurich, Switzerland. “We are seeing improvement in software and customized treatment modalities.”

However, there still is room for improvement, Dr. Mrochen said.

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For instance, efficacy and predictability could be improved for high myopia or myopic astigmatism, hyperopia and hyperopic astigmatism, presbyopia correction, and irregular cornea and higher-order aberration correction.

Although refractive lasers are very safe and effective, they could still be made safer to avoid dry eye issues, flap-related complications, epithelium and biomechanical considerations, and the ability to reverse treatments (such as in patients with presbyopia), Dr. Mrochen said.

There are even improvements that could be made in the realm of convenience, such as the consideration of a patient’s fear about surgery or the ability for the surgeon to make easy treatment decisions and planning.

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Some technology under way is already aiming toward improvements in these areas, Dr. Mrochen said.

For example, the introduction of ray-tracing ablation profiles that consider individual eye models will help boost refractive predictability.

“There’s a huge potential with treatment planning in this area,” he said.

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