J Korean Ophthalmol Soc.  2013 Feb;54(2):224-230. 10.3341/jkos.2013.54.2.224.

Analysis of Enhancement Rate According to Age after Refractive Surgery with Schwind Amaris

• Kim WK
• Yang H
• Cho EY
• Kim HS
• Kim JK

• KMID: 2216656
• DOI: http://doi.org/10.3341/jkos.2013.54.2.224

Abstract

PURPOSE
To evaluate the clinical effects of an automatic energy-lowering system in patients over the age of 28 years with Schwind Amaris laser platform by analyzing the enhancement operation rate according to age.
METHODS
A total of 20448 eyes from 10224 patients who received a bilateral LASIK or LASEK operation with the Schwind Amaris laser platform between August 2007 and April 2011 in our clinic were included in the present study. The rate of enhance operation due to undercorrection was analyzed to determine whether the age affects the enhancement operation rate.
RESULTS
There were a total of 17 enhancement operations. Fifteen out of 17 eyes who received the enhanced operation were above the age of 28 years (p=0.005). In multivariate analysis, patient age over 28 years (OR=6.75, CI 1.54-29.60, p=0.011), preoperative higher spherical equivalent (OR=0.56, CI 0.41-0.77, p=0.0004) and preoperative higher mean keratometric value (OR=1.38, CI 1.01-1.88, p=0.043) were significantly associated with a higher enhancement operation rate.
CONCLUSIONS
Surgeons should be aware that the amount of laser energy from Schwind Amaris laser platform is automatically reduced in patients above the age of 28 years. Therefore, the nomogram should be adjusted to reduce the enhancement operation rate for a specific age group, especially in patients with higher preoperative myopic errors and steeper cornea.

Keyword

Enhancement operation; LASIK; Nomogram; Schwind Amaris laser; Undercorrection

MeSH Terms

Composite Resins
Cornea
Eye
Humans
Keratectomy, Subepithelial, Laser-Assisted
Keratomileusis, Laser In Situ
Multivariate Analysis
Nomograms
Refractive Surgical Procedures
Composite Resins

Figure

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  Figure 1. The distribution of 17 enhanced eyes according to age at operation. yrs = years.

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  Figure 2. Comparison of linear cornea biomechanics change with age and stepwise auto adjustment of laser energy of Schwind Amaris. The lower triangle may explain relatively high enhancement procedure rate at this age range.

Reference

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