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Moderator
Camille Bosc, MD
Panelists
Rushad C. Shroff, MS
Viewing Papers
Expand a paper title to the right to view the paper abstract and authors. Use the video link to jump to that poster in the session.
Presenting Author
Caroline R Duksta, BSc
Co-Authors
Okezie Igboeli (MD), Matthew Kim (BSc), Haana McMurray (MD, BSc), Sorana Raiciulescu (MSc), Christiaan Kroesen (MD)
Purpose
To compare Laser-Assisted In Situ Keratomileusis (LASIK) outcomes for hyperopic patients with high astigmatism (HA; ?2 D) versus low astigmatism (LA; <2 D).
Methods
This was a retrospective cohort study which compared refractive outcomes in hyperopic patients who underwent LASIK for HA (?2 D; n=43) versus LA (<2 D; n=146) in a single military medical refractive surgical center. Only right eyes were included to avoid intereye correlation. Patients with prior corneal pathology, monovision treatment plans, surgical complications, or postsurgical drop noncompliance were excluded. Postoperative spherical equivalent, spherical, and cylindrical error, along with visual acuity, were compared between the two groups at 1, 3 and 6 months.
Results
There were no significant differences in preoperative spherical refractive error (p=0.07) between the two groups. Postoperatively, the HA group had significantly greater mean cylindrical error at 1 month (HA -0.8±0.5D vs LA -0.4±0.3D;p<0.001), 3 months (HA -0.7±0.4D vs LA -0.4±0.3D;p<0.001), and 6 months (HA -0.9±0.3 vs LA -0.4±0.3D;p<0.001) but no significant differences in spherical or spherical equivalent (SE) error. A significantly greater percentage of patients in the LA group also achieved postoperative cylindrical errors of ?0.5D at 1 month (LA 74.3% vs HA 37.8%;p<0.001), 3 months (LA 75.0% vs HA 46.2%;p=0.005), and 6 months (LA 84.8% vs HA 21.1%;p<0.001). Similarly, a significantly higher percentage of patients in the HA group was found to have postoperative cylindrical errors of >1.0D at 1 month (HA 29.7% vs LA 3.7%;p<0.001), 3 months (HA 23.1% vs LA 2.2%;p=0.009), and 6 months (HA 15.8% vs LA 1.3%;p=0.004). Despite significant differences in postoperative refractive error, uncorrected distance visual acuities were comparable between groups at all postoperative timepoints.
Conclusion
In this 6-month study of hyperopic patients undergoing LASIK, patients with HA were more likely to have greater amounts of postoperative cylindrical error but similar amounts of postoperative spherical and spherical equivalent error. Despite differences in postoperative cylindrical error, uncorrected visual acuity was comparable at all time points.
Presenting Author
Siddharth Limaye, BSc
Co-Authors
Eric Moran (MD, BSc), Helen Kemprecos (BSc), Bhargavee Gnanasambandam (MS), Erica Person (MD), Daniel Kim (BSc), Kristy Lin (BSc)
Purpose
To evaluate outcomes following Clear Lens Exchange (CLE) with Multifocal IOL (mfIOL), including postoperative visual acuity, refractive error, patient satisfaction, and spectacle independence.
Methods
A systematic review and meta-analysis of CLE with mfIOL implantation was performed using PubMed. Randomized controlled trials and clinical trials since 2017 were included, and studies of patients with visually significant cataracts were excluded. Twenty-nine studies with 25,799 patients (51,271 eyes) were included. Postoperative uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), residual spherical error (SE), proportion of patients willing to recommend the procedure, and spectacle independence were analyzed. A random effects model was used for pooling statistics for each of the outcomes.
Results
Postoperative UDVA was 0.037 logMAR [0.015, 0.060] and UNVA was 0.110 logMAR [0.055, 0.166]. Residual SE was -0.149 D [-0.279, -0.020]. Satisfaction was 93.0% [91.6%, 94.1%] and spectacle independence was 94.5% [85.3%, 98.1%]. All intervals were calculated at a 95% confidence level.
Conclusion
High patient satisfaction and spectacle independence were achieved with multifocal lenses available since 2017. These results are helpful for setting postoperative expectations for patients undergoing CLE with mfIOL. Further analysis should assess adverse event rates and outcomes for hyperopic and myopic subgroups.
Presenting Author
Mark C. Lobanoff, MD
Purpose
To examine patient subjective responses regarding vision quality, satisfaction of perceived outcomes, and quality of life following wavelight plus LASIK.
Methods
This study was a single site, single-arm, prospective, observational study of patient reported vision quality, satisfaction, and quality of life after successful bilateral wavelight plus LASIK surgery. The plan was to enroll a total of 60 subjects at one site and assess them 6 months post-operatively. Data were collected for visual acuity, manifest refraction, and subjects were asked to complete an adapted patient reported outcomes with LASIK (PROWL) questionnaire.
Results
To date, 14 subjects have completed the study. At 6 months postoperatively, mean UDVA and CDVA were -0.15 ± 0.08 and -0.16 ± 0.07, respectively. Also, 100% of patients reported being “Completely Satisfied” or “Very Satisfied” with their vision. In addition, 100%, 82%, 72%, and 81% of subjects reported “Never” or “Rarely” experiencing double images, glare, halos, and starbursts, respectively, while 100%, 100%, 91%, and 91% of subjects reported “No difficulty” or “Very little difficulty” doing their usually activities because of these same visual disturbances, respectively. Furthermore, 100% of patients said they would choose to have the procedure again and 100% would recommend it.
Conclusion
At 6 months post-surgery, interim results indicate excellent visual outcomes, high patient satisfaction, and low reports of visual disturbances following wavelight plus LASIK.
Presenting Author
Robert Chung, MD
Co-Authors
Gabriel Valerio (MD), Kevin Chen (MD)
Purpose
To describe the practices and outcomes of refractive lens exchange surgery in a unique, pre-presbyopic, military population.
Methods
This was a retrospective, observational analysis of 161 eyes of 81 pre-presbyopic patients (26±5 years old; 84% men) who were identified from the operative records at the refractive surgery centers of two military medical facilities in California and who had refractive lens exchange (RLE) between September 2010 and May 2025. Pre-operative spherical equivalent was +5.4±1.8 D (minimum -3.0 D, maximum 9.6 D). Post operative data was obtained for as long as they were followed in the military, with an average follow up time of 10.9 months.
Results
Two eyes were treated with multifocal IOLs, 49 with toric IOLs, 34 with toric/Extended Depth of Focus IOLs, and 63 with monofocal IOLs. 61 eyes were enhanced with corneal refractive surgery (CRS) after RLE. UCVA was better than or equal to 20/40 in 77.0% of eyes after RLE alone and 91.9% after CRS enhancement. In 76% of patients, the achieved SE was within 1 D of predicted SE after RLE alone. BCVA was unchanged or improved in 67.1% of eyes. Complications included posterior capsular opacity (12 eyes), post-op IOP spikes (9 eyes), presumed HSV flare (1 eye), IOL repositioning (3 eyes), and intermittent esotropia (1 patient). No incidence of endophthalmitis was recorded.
Conclusion
RLE previously has been used as a treatment for presbyopia with multiple refractive options and as a means of decreasing the HOAs associated with higher magnitudes of corneal refractive surgery. The outcomes from this population show that RLE plays a role in treating refractive error in a pre-presbyopic, military, population as well.
Presenting Author
Mark C. Lobanoff, MD
Co-Authors
Ronald Krueger (MD, MSE)
Purpose
To obtain consensus and generate initial real-world data to support a LASIK technology utilizing Ray Tracing technology and a 3D model of the eye to create a personalized vision correction plan evaluated across the domains of workflow, training time, surgeon / staff satisfaction, diagnostic efficiency, patient satisfaction, and patient outcomes.
Methods
Leverage the modified Delphi approach to survey a panel of 10 expert refractive surgeons, including two members of the steering committee (SC), across 3 rounds of voting, to establish consensus related to the observed benefits of this personalized LASIK technology. The Round 1 electronic pre-panel questionnaire was designed to gather initial perspectives, information gathering and further refine consensus statements. Round 2 will include a virtual panel discussion, with a second round of voting. Round 3 will conclude with a post-panel questionnaire to document the level of agreement and consensus on the proposed consensus statements.
Results
An analysis will be conducted based on the 3 rounds of voting by the panel of expert refractive surgeons, generating quantitative and qualitative data to support value statements that differentiate the personalized LASIK technology from the current modalities offered related to workflow, training time, surgeon / staff satisfaction, diagnostic efficacy, patient satisfaction, and patient outcomes.
Conclusion
Through a modified Delphi process, consensus will be reached to document real-world evidence evaluating differential perceived value for a personalized LASIK technology designed to improve both end-user and patient satisfaction.
Presenting Author
Megan E. Chung, BA
Co-Authors
Edward Manche (MD)
Purpose
To evaluate visual outcomes in patients with myopia or compound myopic astigmatism in wavefront-guided laser in situ keratomileusis (WFG-LASIK) and photorefractive keratectomy (WFG-PRK) surgery performed by corneal fellows in training.
Methods
One hundred thirty-seven eyes of 69 consecutive patients with no history of refractive surgery underwent WFG-LASIK or WFG-PRK from March 2017 to October 2024 in our prospective, nonrandomized clinical trial. Patients had preoperative refractive errors with sphere up to -10.25 diopters (D), cylinder up to 4.50 D, with a maximum spherical equivalent (SE) of -10.00 D. All eyes were targeted for emmetropia. The mean preoperative SE refraction was -3.87 ± 1.95 D and -5.08 ± 2.30 D in the WFG-LASIK and WFG-PRK groups, respectively. The primary outcome measure was uncorrected distance visual acuity (UDVA) at 12 months. Secondary outcome measures included safety and predictability.
Results
At postoperative month twelve, 81.3% of eyes in the WFG-LASIK group achieved UDVA of 20/20 or better, 25.0% of eyes achieved 20/15 or better, 100% of eyes achieved manifest refraction SE (MRSE) within 0.50 D of target, mean SE was -0.06, and no eyes lost more than 2 lines of corrected distance visual acuity (CDVA). In patients who underwent WFG-PRK, 94.7% of eyes achieved UDVA of 20/20 or better, 15.8% of eyes achieved 20/15 or better, 89.5% of eyes achieved MRSE within 0.50 D of target, mean SE was -0.24, and no eyes lost more than 2 lines of CDVA.
Conclusion
WFG-LASIK and WFG-PRK performed by corneal fellows in training achieved excellent safety, efficacy, and predictability for the correction of myopia and compound myopic astigmatism.
Presenting Author
Maya S. Goyal, BSc
Co-Authors
Karl Stonecipher (MD)
Purpose
To evaluate and compare the visual outcomes of LASIK using three different ablation profiles on the Wavelight Laser in 1,299 eyes, with femtosecond-created flaps using the FS200.
Methods
This retrospective, single-surgeon, single-center study analyzed 1,299 eyes to assess outcomes with the latest laser ablation profiles on the Wavelight Laser, Visual performance, including uncorrected distance visual acuity (UCDVA, logMAR), spherical outcomes, astigmatic correction, and enhancement rates, was compared across Wavefront Optimized (WFO), Topography-Guided (TCAT), and Wavelight® Plus (RTG) platforms.
Results
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Conclusion
LASIK outcomes are constantly improving with evolving laser technology. This comparative analysis illustrates differences in patient profiles, platform-specific strengths, and clinical indications, providing practical guidance for optimizing refractive surgery outcomes.
Presenting Author
Buki Kim, MD
Purpose
To compare the clinical outcomes of implantable collamer lens (ICL) implantation and photorefractive keratectomy (PRK) as retreatment options for regressed myopia or myopic astigmatism following laser vision correction (LVC).
Methods
This retrospective comparative study analyzed 30 eyes treated with ICL implantation and 24 eyes treated with transepithelial PRK. Eyes that had regressed myopia or myopic astigmatism after prior LVC and had completed a 6-month follow-up were included. Clinical outcomes and vector analysis of astigmatic correction were compared.
Results
At 6 months, 100% of eyes in the ICL group and 92% in the PRK group achieved a postoperative SE within ±1.00 D, with UDVA of 20/20 or better observed in 100% and 96% of eyes, respectively. The ICL group showed significantly better UDVA at 1 week and 1 month postoperatively (p < 0.001 and p = 0.005), while no differences were observed at 3 and 6 months. Refractive stability over 6 months was superior in the ICL group (p = 0.095 and p = 0.040 in the ICL and PRK groups, respectively). Vector analysis revealed a tendency toward undercorrection in the ICL group and overcorrection in the PRK group, with the PRK group showing significantly greater surgically induced astigmatism (p = 0.045)
Conclusion
Both ICL implantation and PRK are safe and effective retreatment options for myopic regression after LVC. ICL demonstrated faster early visual recovery and greater refractive stability, while PRK showed higher astigmatic correction with a trend toward overcorrection.
Presenting Author
Ivan Gabric, MD
Purpose
To investigate the rate and rationale for surgical enhancements after primary SmartSight procedures and compare outcomes among different enhancement techniques—including PRK, conversion of cap to flap, and a secondary SmartSight treatment—in a large cohort of 2698 eyes over multiple years.
Methods
We retrospectively reviewed 2,698 post-SmartSight eyes, of which 59 (2.19%) required retreatment, mostly within two years. In the past 12 months, among 1,200 eyes, the rate fell to 0.5%. Indications included residual refractive error (mean SE −0.75D, range +1.25 to −1.50D, with >0.75D astigmatism), optical zone/axis mismatch, and HOAs (n=6). Retreatment methods were PRK in 31 eyes, cap-to-flap conversion with Schwind ATOS in 27 (1 later needing PRK, 1 with flap complication), and repeat SmartSight in 1 eye under the original cap.
Results
PRK enhancements were uncomplicated but entailed a longer recovery. In contrast, cap-to-flap conversion and secondary SmartSight delivered rapid, pain-free recovery with minimal downtime from postoperative day one. Despite these early postoperative differences, the long-term visual results across all enhancement methods were comparable, and flap-related complications were minimal
Conclusion
Enhancement after SmartSight occurred in 2.19% of cases, mostly early in the series. In the last 12 months, the rate dropped to 0.5% (1,200 eyes), reflecting improvement and a learning-curve effect. All methods were safe and effective; flap-based offered faster recovery, while PRK matched outcomes long-term but healed slower.
