Advanced Surface Ablation With a New Software for the Reduction of Ablation Irregularities

PURPOSE: To compare visual outcomes and postoperative aberrations after surface ablation performed with a 750-Hz versus a 1,050-Hz excimer laser coupled with an ablation software designed to reduce corneal surface irregularity. METHODS: Retrospective comparative trial of myopic eyes that had refractive surgery consecutively treated with transepithelial advanced surface ablation with a 750-Hz excimer laser (750 group) versus a 1,050-Hz excimer laser coupled with the Smart Pulse Technology ablation software (SPT group). The SPT algorithm is a laser pulse technology software aimed at reducing surface irregularity of the stromal bed at the end of treatment. The authors evaluated the effect of this smoothing on final visual acuity. Patients were observed for 6 months. RESULTS: A total of 139 eyes in the 750 group and 40 eyes in the SPT group were evaluated. Epidemiological and preoperative refractive data of the two groups were comparable. Uncorrected distance visual acuity improved with time and was significantly better in the SPT group (−0.04 ± 0.61 logMAR for the SPT group vs 0.02 ± 0.78 logMAR for the 750 group) ( P < .001). At 6 months, 55% versus 21% achieved 20/16 or better ( P = .005) and 90% versus 65% achieved 20/20 or better ( P = .019) visual acuity in the SPT and 750 groups, respectively. Corrected distance visual acuity improved with time and appeared to be influenced by group ( P = .054), with better results in the SPT group. Coma and trefoil improved significantly with time in a similar manner in both groups. CONCLUSIONS: Surface ablation with the 1,050-Hz excimer laser and SPT software, aimed at reducing the final superficial stromal irregularity, led to improvement of 6-month uncorrected visual acuity. [ J Refract Surg. 2017;33(2):89–95.]