Purpose: To evaluate the performance of the InnovEyes Sightmap platform (Alcon Laboratories, Inc) in refractive surgery by comparing the visual acuity and higher order aberrations (HOAs) between ray-tracing-guided laser in situ keratomileusis (LASIK) and topography-guided LASIK.
Methods: This prospective study enrolled participants who underwent either ray-tracing-guided LASIK or topography-guided LASIK. Comprehensive ophthalmic evaluations were performed preoperatively, as well as at 1 day, 2 weeks, 1 month, and 3 months postoperatively. Patients in the ray-tracing-guided LASIK group underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap diagnostic device. Assessments included visual acuity, manifest refraction, and whole-eye HOAs.
Results: A total of 42 eyes treated with ray-tracing-guided LASIK and 42 eyes treated with topography-guided LASIK were analyzed. Both strategies demonstrated comparable good refraction accuracy and refractive stability (P > .05). The ray-tracing-guided LASIK group exhibited significantly better postoperative uncorrected distance visual acuity (UDVA) compared to the topography-guided LASIK group (-0.12 ± 0.05 vs -0.07 ± 0.04 logarithm of the minimum angle of resolution, respectively; P < .05), with 48% of eyes achieving a UDVA of 20/12.5 or better. Ray-tracing-guided LASIK induced a small but statistically significant increase in HOAs and vertical coma aberration, along with a significant reduction in spherical aberration (P < .05). In contrast, topography-guided LASIK resulted in a significant increase in vertical coma (P < .05) without significant changes in overall HOAs or spherical aberration (P > .05). At 3 months postoperatively, spherical aberration was significantly different between the two groups (-0.021 ± 0.031 vs 0.054 ± 0.122 µm, respectively; P < .05).
Conclusions: The InnovEyes Sightmap platform's ray-tracing-guided LASIK demonstrated potential advantages in visual acuity outcomes compared to topography-guided LASIK. The observed negative shift in spherical aberration, characterized by a lower absolute value, may have contributed to the enhanced visual acuity results. [J Refract Surg. 2024;40(12):e994-e1002.].