Aspherical optical zones:

The effective optical zone with the Schwind AMARIS

Erika N. Eskina, MD1,
Victoria Parshina1,Olga Mironenko, PhD1
Yuri Kolmakov1

Samuel Arba-Mosquera, PhD2,*

(1) Laser Surgery Clinic SPHERE, Moscow, Russia
(2) SCHWIND eye-tech-solutions, Kleinostheim, Germany
FINANCIAL DISCLOSURE:
The authors have no financial or proprietary interest in a product, method, or material described.
Dr. Arba Mosquera and Thomas Magnago are employees of SCHWIND eye-tech-solutions.

Purpose:
To evaluate the functional optical zone (FOZ) and influencing parameters among eyes that underwent surface
treatments for myopic astigmatism with PRK , TransPRK or LASIK.

Settings:
Prof. Erika N. Eskina, MD, Laser Surgery Clinic SPHERE, Moscow, Russia

Methods:
16 patients (32 eyes) treated with
16 patients (32 eyes) treated with
16 patients (32 eyes) treated with LASIK using Pendular microkeratome (SCHWIND eye-tech-solutions)
using the SCHWIND AMARIS flying-spot excimer laser system (SCHWIND eye-tech-solutions) were analysed at
six-month.
We analysed the influence of the following parameters:
OZ Planned, FOZ preop, K readings in 4 mm zone preop, SPH inputted, CYL inputted, pachymetry in the centre
of the cornea, age and type of operation

Parameters and Statistics

Clinical outcomes were evaluated in terms of functional optical zone (FOZ), effective optical
zone (EOZ), planned optical zone (POZ),
POZ=Optical zone selected in the software where the full amount of refractive correction is
applied.
FOZ = defined as the area (diameter) where the RMS HO value exceeds 0.50D the first time (the
search starts from the center to the periphery of each map).
EOZ = post-op FOZ
Multilinear regression analyses started with full degrees of freedom and
applied stepwise regression

a P value less than 0.05 was considered statistically significant

We also used Ordinary least square method, Mann-Whitney U-test,
Coefficient of determination (R2) and Wilcoxon signed-rank test

Group description

RESULTS - Optical Zone

Planned OZ
deviation

OZ PostOp

OZ Planned

Change of OZ
postop

OZ PreOp

The level of significance in difference in OZ postOp and planned TransPRK and PRK groups is 8%.
For PRK and LASIK groups is 9%
For LASIK and TransPRK is 68% (not significant at all)

POZ deviation in a relation to ablation depth and EOZ

POZ Deviation

POZ deviation in a relation to K readings and EOZ

7
OZ post OP

OZ, mm

RESULTS EOZ (planned) deviation in TransPRK Group

3
1

11 13 15 17 19 21 23 25 27 29 31
CASES
OZ plan

6
OZ plan

OZ post OP

Scattergramm represents the reduction in the effective OZ in majority of cases

7
OZ post OP

OZ, mm

RESULTS EOZ (planned) deviation in PRK Group

6
5

3
3

9 11 13 15 17 19 21 23 25 27 29 31

6
OZ plan

CASES
OZ plan

OZ post OP

Scattergramm represents the reduction in the effective OZ in all cases

7
OZ post OP

OZ, mm

RESULTS EOZ (planned) deviation in LASIKGroup

6
5

3
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
CASES

OZ plan

6
OZ plan

OZ post OP

Scattergramm represents the reduction in the effective OZ in majority of cases

Multiple regression
analysis results

EOZ planning
EOZpostOP
=
3.144
+
0.688*OZplan
+
0.170*OZpreOPi + 0.393*SPHi + 0.175*CYLi +
0.003*PACHi 0.058*K2i 0,008*Agei + 0.319*D1i +
0.461*D2i
where:
OZplan OZ planned, PACH pachymetry in the center of the cornea; K2 K
reading in the flat meridian; Age patient age; D1 is a binary parameter =1 if
there is a PRK planned,0 if there is other type of surgery planned; D2 is a
binary parameter =1 if there is a TransPRK planned, 0 if there is other type of
surgery planned

EOZ planning

Conclusion

The results of the analysis offer us a possibility to make a real planning of OZ postop and increase the quality of
optics for patienrs operated

The mathematical modeling of the factors, which influencing the EOZ could be described by the formula:

EOZpostOP = 3.144 + 0.688*OZplan + 0.170*OZpreOPi + 0.393*SPHi + 0.175*CYLi +

0.003*PACHi 0.058*K2i 0,008*Agei + 0.319*D1i + 0.461*D2i
Take home message:

Decreasing of EOZ means only higher, than was planned, level of aberrations caused by
ablation

EOZ decreasing with increasing a level of myopia and astigmatism.

Planning an additional 1 mm OZ you should input at least for PRK 1,13 mm, for TransPRK
1,09 mm and for LASIK 1,06 mm

Thank you for your kind attention!