Method for Optimizing Topography-guided Ablation of Highly Aberrated Eyes With the ALLEGRETTO WAVE Excimer Laser
Bibliographic record
Abstract
PURPOSE: To evaluate the clinical outcomes of custom topographic neutralizing technique in treating highly aberrated eyes using the WaveLight ALLEGRETTO WAVE Excimer Laser. METHODS: A retrospective consecutive case series of 67 eyes with decentered ablations and 48 eyes with symptomatic small optical zones after previous LASIK underwent topography-guided retreatment with the ALLEGRETTO WAVE. Sixteen keratoconus eyes underwent topographic neutralizing technique photorefractive keratectomy (PRK). The study assessed preoperative and 6-month and 1-year postoperative results regarding best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), topography, and predictability. RESULTS: Sixty-seven eyes with previously decentered optical zones had an improvement of centration from 0.92 mm preoperatively to 0.30 mm postoperatively relative to pupil center (P<.01). Twenty-nine percent of these eyes gained 1 or more lines of BSCVA, whereas 71% had no change in BSCVA. Forty-eight eyes with previously small optical zones had an increase of the central monodioptric optical zone from 3.9 mm to 5.6 mm (P<.01). Nineteen percent of eyes had an improvement of at least 1 line, whereas 75% had no change in BSCVA and 6% lost 1 line. Sixteen keratoconus eyes had custom topographic neutralizing technique PRK as an alternative to penetrating keratoplasty. All eyes had improvement of astigmatism up to 5.00 diopters (D), with a mean change of 1.68+/-1.62 D. Best spectacle-corrected visual acuity was unchanged in 8 (50%) eyes, with 4 (25%) eyes gaining 1 line, 2 (12%) eyes gaining 2 lines, and 2 (12%) eyes losing 1 line of BSCVA at 6 months. CONCLUSIONS: Management of some highly aberrated eyes is now possible with topography-guided ablation using the WaveLight ALLEGRETTO platform and custom topographic neutralizing technique. Safety was acceptable for small optical zone and decentered ablation retreatments. The topography-guided ablation could be an alternative treatment for keratoconus patients if keratoplasty is otherwise indicated. The algorithms for custom topographic neutralizing technique need further refinement.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".