Treatment of high myopia/myopic astigmatism with a combination of WaveLight Contoura with LYRA protocol and wavefront-optimized treatment

PURPOSE: The aim of this article was to demonstrate how WaveLight Contoura and wavefront optimization (WFO) can be used together to treat high myopia/myopic astigmatism corrections. MATERIALS AND METHODS: A retrospective analysis was conducted on 24 consecutive myopic/myopic astigmatism eyes that exceeded the Contoura labeling of −8.00 with −3.00 D of astigmatism. Residual correction after Contoura with Layer Yolked Reduction of Astigmatism protocol was treated with WFO Contoura LASIK correction. All patients had 3 months of follow-up. Accuracy to the desired refractive goal was assessed by postoperative refraction, regression, postoperative vision, and anecdotal subjective night vision quality. RESULTS: No eyes lost best-corrected visual acuity (BCVA), and 54% of eyes gained BCVA. Out of 22 distance eyes, five achieved 20/15 or better, 18 achieved 20/20 vision, two achieved 20/25, and three achieved 20/30 vision. Preoperatively, only 14 eyes could achieve 20/20 vision. No night vision issues were observed in anecdotal reporting by patients except for those who needed enhancements that had not yet been performed. CONCLUSION: Treatment of high myopia/astigmatism with this combination of Contoura with LYRA protocol and WFO results in excellent visual outcomes, large ablation zones on topography, and few subjective reported night vision issues.