ASCRS 2024: LASIK outcomes using an updated laser ablation algorithm for myopia and myopic astigmatism

George O. Waring IV, MD, FACS, provides an overview of his presentation at ASCRS 2024, highlighting outcomes for the safety and effectiveness of LASIK performed using an updated laser ablation algorithm for the correction of myopia and myopic astigmatism.

Video Transcript

Editor's note - This transcript has been edited for clarity.

The thoughts and opinions expressed are those of the author and do not necessarily represent the opinions of this publication.

George O. Waring IV, MD, FACS: Hi, it's George Waring from the Waring Vision Institute in Mount Pleasant, South Carolina. We're here at ASCRS in Boston 2024. Fabulous meeting. One of the things that we're really excited about is the evolving landscape in corneal refractive procedures. Something very significant happened in November 2023 and that was the first FDA approval of a new excimer laser in well over a decade and a half. We had the distinct honor and pleasure of being the first site in the United States to use this new laser [Teneo 317 Model 2, Bausch + Lomb]. It's the second time that we've gotten to do this to introduce the first excimer laser in the country in 15 years. So we're really excited about both opportunities.

Now, we did also participate as an investigator for the FDA clinical trial for myopia and myopic astigmatism. This gave us a tremendous amount of comfort in terms of understanding how this laser works. But what are some of the key features and why we're so excited about this technology?

Number one: It's the fastest laser in the United States. It treats a diopter in 1.2 seconds with a truncated Gaussian beam that leads to very, very efficient treatments. This is at a repetition rate of 500 Hertz and an eye tracker that's three times faster. So the big news on this is that there's no nomogram required and no physician adjustment required. So this is an internal adjusted system optimized for the manifest refractive spherical equivalent [MRSE] with what's called Proscan, which is essentially a wavefront optimized-type treatment. So very, very exciting stuff.

So what about the results? We had 333 eyes enrolled, and with a really fabulous outcome: 98% of patients greater than 20/25 vision uncorrected for distance. But over half of patients were 20/16 or better. Close to a third of patients gained 1 line of corrected distance visual acuity. And very exciting when we looked at the manifest refractive spherical equivalent at 9 months, -0.04 diopters. We have never seen results like this in the peer-reviewed literature.

Furthermore, this was the first laser to date that we've seen improve contrast sensitivity that was measured postop relative to preop with an excimer laser system. Very exciting. That suggests qualitative improvement in visual acuity. The patient-reported outcomes mirrored this as well. Close to a quarter of patients were dissatisfied with their vision beforehand, before treatments, and over 95% of patients were satisfied with their vision after their treatments, too. So we have qualitative and quantitative signals that patients are really, really doing great.

So we are super thrilled for this technology. This really is moving the needle. It's more efficient. It's less than about a half of the size of the footprint of other lasers in the US. And with no nomogram makes us much more intuitive, reduces the chance for input error, and is just really providing a wonderful result from minus one to minus 10. And minus zero to minus three diopters of myopic astigmatism. These were the indications we studied in the FDA trial, and to end up with that type of of uncorrected visual result and MRSE. Very, very impressed.