Comparison of Patient-Specific Computational Modeling Predictions and Clinical Outcomes of LASIK for Myopia

To assess the predictive accuracy of simulation-based LASIK outcomes. Preoperative and 3-month post-LASIK tomographic data from 20 eyes of 12 patients who underwent wavefront-optimized LASIK for myopia were obtained retrospectively. Patient-specific finite element models were created and case-specif...

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Vydáno v:Investigative ophthalmology & visual science Ročník 57; číslo 14; s. 6287 - 6297
Hlavní autoři: Seven, Ibrahim, Vahdati, Ali, De Stefano, Vinicius Silbiger, Krueger, Ronald R., Dupps, William J.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States The Association for Research in Vision and Ophthalmology 01.11.2016
Témata:
Adult
Cornea
Cornea - pathology
Cornea - surgery
Corneal Topography - methods
Feasibility Studies
Female
Follow-Up Studies
Humans
Keratomileusis, Laser In Situ - methods
Male
Myopia - pathology
Myopia - physiopathology
Myopia - surgery
Patient-Specific Modeling
Postoperative Period
Refraction, Ocular
Reproducibility of Results
Retrospective Studies
Time Factors
Visual Acuity
ISSN:1552-5783, 0146-0404, 1552-5783
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Abstract To assess the predictive accuracy of simulation-based LASIK outcomes. Preoperative and 3-month post-LASIK tomographic data from 20 eyes of 12 patients who underwent wavefront-optimized LASIK for myopia were obtained retrospectively. Patient-specific finite element models were created and case-specific treatment settings were simulated. Simulated keratometry (SimK) values and the mean tangential curvature of the central 3 mm (Kmean) were obtained from the anterior surfaces of the clinical tomographies, and computational models were compared. Correlations between Kmean prediction error and patient age, preoperative corneal hysteresis (CH), and corneal resistance factor (CRF) were assessed. The mean difference for Kmean between simulated and actual post-LASIK cases was not statistically significant (-0.13 ± 0.36 diopters [D], P = 0.1). The mean difference between the surgically induced clinical change in Kmean and the model-predicted change was -0.11 ± 0.34 D (P = 0.2). Kmean prediction error was correlated to CH, CRF, and patient age (r = 0.63, 0.53, and 0.5, respectively, P < 0.02), and incorporation of CH values into predictions as a linear offset increased their accuracy. Simulated changes in Kmean accounted for 97% of the variance in actual spherical equivalent refractive change. Clinically feasible computational simulations predicted corneal curvature and manifest refraction outcomes with a level of accuracy in myopic LASIK cases that approached the limits of measurement error. Readily available preoperative biomechanical measures enhanced simulation accuracy. Patient-specific simulation may be a useful tool for clinical guidance in de novo LASIK cases.
AbstractList To assess the predictive accuracy of simulation-based LASIK outcomes.PurposeTo assess the predictive accuracy of simulation-based LASIK outcomes.Preoperative and 3-month post-LASIK tomographic data from 20 eyes of 12 patients who underwent wavefront-optimized LASIK for myopia were obtained retrospectively. Patient-specific finite element models were created and case-specific treatment settings were simulated. Simulated keratometry (SimK) values and the mean tangential curvature of the central 3 mm (Kmean) were obtained from the anterior surfaces of the clinical tomographies, and computational models were compared. Correlations between Kmean prediction error and patient age, preoperative corneal hysteresis (CH), and corneal resistance factor (CRF) were assessed.MethodsPreoperative and 3-month post-LASIK tomographic data from 20 eyes of 12 patients who underwent wavefront-optimized LASIK for myopia were obtained retrospectively. Patient-specific finite element models were created and case-specific treatment settings were simulated. Simulated keratometry (SimK) values and the mean tangential curvature of the central 3 mm (Kmean) were obtained from the anterior surfaces of the clinical tomographies, and computational models were compared. Correlations between Kmean prediction error and patient age, preoperative corneal hysteresis (CH), and corneal resistance factor (CRF) were assessed.The mean difference for Kmean between simulated and actual post-LASIK cases was not statistically significant (-0.13 ± 0.36 diopters [D], P = 0.1). The mean difference between the surgically induced clinical change in Kmean and the model-predicted change was -0.11 ± 0.34 D (P = 0.2). Kmean prediction error was correlated to CH, CRF, and patient age (r = 0.63, 0.53, and 0.5, respectively, P < 0.02), and incorporation of CH values into predictions as a linear offset increased their accuracy. Simulated changes in Kmean accounted for 97% of the variance in actual spherical equivalent refractive change.ResultsThe mean difference for Kmean between simulated and actual post-LASIK cases was not statistically significant (-0.13 ± 0.36 diopters [D], P = 0.1). The mean difference between the surgically induced clinical change in Kmean and the model-predicted change was -0.11 ± 0.34 D (P = 0.2). Kmean prediction error was correlated to CH, CRF, and patient age (r = 0.63, 0.53, and 0.5, respectively, P < 0.02), and incorporation of CH values into predictions as a linear offset increased their accuracy. Simulated changes in Kmean accounted for 97% of the variance in actual spherical equivalent refractive change.Clinically feasible computational simulations predicted corneal curvature and manifest refraction outcomes with a level of accuracy in myopic LASIK cases that approached the limits of measurement error. Readily available preoperative biomechanical measures enhanced simulation accuracy. Patient-specific simulation may be a useful tool for clinical guidance in de novo LASIK cases.ConclusionsClinically feasible computational simulations predicted corneal curvature and manifest refraction outcomes with a level of accuracy in myopic LASIK cases that approached the limits of measurement error. Readily available preoperative biomechanical measures enhanced simulation accuracy. Patient-specific simulation may be a useful tool for clinical guidance in de novo LASIK cases.
To assess the predictive accuracy of simulation-based LASIK outcomes. Preoperative and 3-month post-LASIK tomographic data from 20 eyes of 12 patients who underwent wavefront-optimized LASIK for myopia were obtained retrospectively. Patient-specific finite element models were created and case-specific treatment settings were simulated. Simulated keratometry (SimK) values and the mean tangential curvature of the central 3 mm (Kmean) were obtained from the anterior surfaces of the clinical tomographies, and computational models were compared. Correlations between Kmean prediction error and patient age, preoperative corneal hysteresis (CH), and corneal resistance factor (CRF) were assessed. The mean difference for Kmean between simulated and actual post-LASIK cases was not statistically significant (-0.13 ± 0.36 diopters [D], P = 0.1). The mean difference between the surgically induced clinical change in Kmean and the model-predicted change was -0.11 ± 0.34 D (P = 0.2). Kmean prediction error was correlated to CH, CRF, and patient age (r = 0.63, 0.53, and 0.5, respectively, P < 0.02), and incorporation of CH values into predictions as a linear offset increased their accuracy. Simulated changes in Kmean accounted for 97% of the variance in actual spherical equivalent refractive change. Clinically feasible computational simulations predicted corneal curvature and manifest refraction outcomes with a level of accuracy in myopic LASIK cases that approached the limits of measurement error. Readily available preoperative biomechanical measures enhanced simulation accuracy. Patient-specific simulation may be a useful tool for clinical guidance in de novo LASIK cases.
Author Seven, Ibrahim
Dupps, William J.
Vahdati, Ali
De Stefano, Vinicius Silbiger
Krueger, Ronald R.
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  organization: Ocular Biomechanics and Imaging Lab, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States 2Refractive Surgery Service, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States 3Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States
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Snippet To assess the predictive accuracy of simulation-based LASIK outcomes. Preoperative and 3-month post-LASIK tomographic data from 20 eyes of 12 patients who...
To assess the predictive accuracy of simulation-based LASIK outcomes.PurposeTo assess the predictive accuracy of simulation-based LASIK outcomes.Preoperative...
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StartPage 6287
SubjectTerms Adult
Cornea
Cornea - pathology
Cornea - surgery
Corneal Topography - methods
Feasibility Studies
Female
Follow-Up Studies
Humans
Keratomileusis, Laser In Situ - methods
Male
Myopia - pathology
Myopia - physiopathology
Myopia - surgery
Patient-Specific Modeling
Postoperative Period
Refraction, Ocular
Reproducibility of Results
Retrospective Studies
Time Factors
Visual Acuity
Title Comparison of Patient-Specific Computational Modeling Predictions and Clinical Outcomes of LASIK for Myopia
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