Wavefront-guided custom ablation for myopia using the NIDEK NAVEX laser system

PURPOSE: To determine the predictability, efficacy, safety, and stability of LASIK using custom ablation with the NIDEK Advanced Vision Excimer Laser System (NAVEX). METHODS: One hundred twenty eyes underwent LASIK for myopia using the OPDCAT algorithm. Refractive outcomes and the change in higher order aberrations, coma, and spherical aberrations were analyzed. Postoperative follow-up ranged from 6 to 18 months. RESULTS: Mean postoperative spherical equivalent refraction was -0.05 diopters (D) (range: -0.92 to +0.88 D). Uncorrected visual acuity was 1 or better in 109 (91%) eyes and 1.2 or better in 47 (39%) eyes. Postoperative spherical equivalent refraction was within +/- 0.50 D of intended correction in 110 (92%) eyes. Fifty-two (43%) eyes gained 1 or more lines of best spectacle-corrected visual acuity (BSCVA), and no eyes lost more than 1 line of BSCVA. Higher order aberrations root-mean-square increased by 0.053 microm postoperatively. Patients with preoperative higher order aberrations > or = 0.3 microm were less likely to have induced higher order aberrations. CONCLUSIONS: Wavefront-guided OPDCAT treatments with the NIDEK NAVEX system for myopia are safe and effective with excellent visual acuity and refractive outcomes. Eyes with > or = 0.3 microm of higher order aberrations preoperatively will benefit more from OPDCAT treatment than eyes with a smaller amount of higher order aberrations.