Understanding the Real Effect of the High-Order Aberrations after Myopic Femto-Lasik

In this work we try to understand the real effect of increase in aberrations after Femto-LASIK surgery on the patient's final visual quality, specifically when the visual acuity measurement is considered. A clinical study with 37 eyes of 20 patients that underwent myopic Femto-LASIK surgery and different personalized eye model simulations were carried out. In clinical study, correlations between pre- and postoperative parameters with visual acuity were analysed. Eye simulations (based on real data) provided simulations of vision quality before and after surgery. Our main results showed a significant increase in aberrations was obtained after surgery; however, no differences were found between the preoperative corrected distance visual acuity (CDVA) and the postoperative uncorrected distance visual acuity (UDVA). This absence of differences in visual quality could be explained by performing different simulations on three eyes that would cover most of the possible clinical situations. Simulations were implemented considering a pupil size of 2.5 mm and the personalized data of each patient. Results showed that final visual acuity (VA) change are determined by the final high-order aberrations (HOAS) and their increase after surgery but measured under photopic conditions. In conclusion, customized analysis of higher-order aberrations in scotopic pupils better predicts patient visual acuity after Lasik surgery.