Customized ablation treatments produce excellent results

July 15, 2005

Washington, DC—The CustomCornea (Alcon Laboratories Inc.) or CustomVue (VISX) platforms seem to offer excellent outcomes in wavefront-guided LASIK for myopia. However, induced aberration appears to be less with CustomCornea treatment, especially after nomogram adjustment for the CustomVue procedure, and that difference is apparent clinically in terms of contrast sensitivity results, according to Stephen G. Slade, MD.

He reported on results from 3 months of follow-up in a prospective, masked, randomized contralateral-eye study at the annual meeting of the American Society of Cataract and Refractive Surgery.

"This is a small study and further investigation may be warranted," said Dr. Slade, director, Laser Center of Houston. "Of interest, however, in a similar investigation we conducted comparing CustomVue treatment with Zyoptix (Bausch & Lomb) treatment, the results favored the Zyoptix group, suggesting there may be some advantage for scanning versus broad-beam lasers."

"With this contralateral eye design, our treatment groups were very well-matched in their preoperative variables, and the surgical variables were also tightly controlled with all procedures performed by a single surgeon using the femtosecond laser microkeratome (IntraLase Corp.). Therefore, we were able to have a statistically powerful study with relatively few patients," Dr. Slade noted.

For the first phase of the study, mean preoperative MRSE was –3.41 D for CustomCornea eyes and –3.34 D for the CustomVue group. However, at 3 months, the uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and accuracy outcomes all favored the CustomCornea treatment as a result of undercorrection of higher levels of myopia with the CustomVue platform.

At 3 months, UCVA was 20/20 or better among 79% of CustomCornea eyes compared with 67% of CustomVue eyes; corresponding rates for UCVA of 20/25 or better were 96% versus 71%. A gain in BCVA was achieved by 32% of CustomCornea eyes compared with 24% of CustomVue eyes, and the only loss in BCVA affected a single eye in the CustomVue group.

Between-group comparisons of higher-order aberrations showed increases in both groups with a statistically significant difference favoring CustomCornea treatment at 1 and 3 months for less induced spherical aberration.