Higher-Order Aberrations Following Ray Trace LASIK and the Impact of Eye Movement on Coma

Purpose: To assess ocular higher-order aberrations (HOAs) following ray trace guided laser in situ keratomileusis (LASIK). Methods: Retrospective review at a single-site ophthalmology practice. Two hundred and fifty eyes of 250 patients with myopia and astigmatism undergoing ray trace LASIK were randomly reviewed (Wavelight Plus, Alcon). The InnovEyes Sightmap (Alcon) diagnostic device was used for whole-eye wavefront aberrometry, tomography, and biometry assessment preoperatively and 3 months post-operatively. Ocular HOA, ablation decentration, intraoperative pupil size, and pupil tracking were assessed. Intraoperative eye tracking of x and y coordinates were separately averaged to calculate mean and standard deviation of movement along the x-axis and y-axis to assess eye movement. Results: =0.34, p < 0.001, respectively). Multivariate analysis further showed this was correlated to eye movement. Conclusion: Ray trace LASIK results in a minimal increase in total ocular HOA which is statistically but not clinically significant. Spherical aberration decreases. In larger treatments, there is an increase in coma which correlates with vertical and horizontal decentration of ablation, likely due to eye movement during surgery.