Cole Eye Institute Outcomes
About Refractive Surgery
Refractive surgery involves modification of the eye’s focusing power, usually through laser treatment of the cornea, to reduce or eliminate a patient’s dependence on glasses or contact lenses. Surgeons at Cole Eye Institute use 3 laser platforms: the Alcon WaveLight® Refractive Suite (EX 500 excimer laser and FS200 femto laser), the VISX™ Star S4 excimer laser, and the ZEISS VisuMax® laser for making flaps or performing a newer procedure called SMILE (small incision lenticular extraction). Outcomes are subdivided based on the type of surgery and the patient’s preoperative refractive status (low/moderate myopia [0 to -7.00 diopters (D)] and high myopia [> -7.00 D]). Both the type and magnitude of refractive error can affect the likelihood that uncorrected visual acuity (UCVA) of 20/20 or better will be achieved. Another important criterion in assessing laser vision correction outcomes is the proportion of patients whose final refractive error falls within ± 0.5 D of the intended result.
This section documents outcomes for laser in situ keratomileusis (LASIK) with a femtosecond laser (FS200) flap or a Visumax flap (FemtoLASIK) and photorefractive keratectomy (PRK) (i.e., surface ablation) using the wavefront optimized (WFO) ablation profile of the Alcon WaveLight EX 500 excimer laser, as well as the VISX Star S4 platform, which is all-inclusive of customized and standard ablation profiles. In 2016, surgeons at the institute began offering a new topography-guided profile of laser treatment called Contoura™ Vision that offers further customization of the treatment based on an individual eye’s corneal shape. Contoura Vision can be applied with LASIK or PRK and uses the Alcon platform. Outcomes are reported as the percentages of eyes with UCVA of 20/20 or 20/25, eyes with an exceptional outcome (UCVA of 20/16 or even 20/12), and eyes with UCVA meeting the requirements for driving without glasses (20/40 or better). This analysis includes the outcomes of 385 eyes treated in 2018 with the Alcon platform (including 198 using Contoura Vision) and 89 eyes treated with the VISX platform.
Some patients are not candidates for laser vision correction by LASIK, PRK, or SMILE, but may be candidates for lens implants (Visian® ICL and Visian Toric ICL phakic intraocular lenses for correcting high myopia or myopic astigmatism, respectively) or refractive lens exchange surgery.