Multizone model for postsurgical corneas: analysis of standard and custom LASIK outcomes.

A multizone model for postsurgical corneal topography is presented and applied to a comparative analysis of the outcome of standard and customized myopic LASIK. The different zones are segmented automatically by a clustering algorithm. The algorithm uses a set of three local descriptors, which correspond to normalized physical magnitudes computed for each point of the corneal topography map: Gauss curvature, root-mean-square (RMS) fit error to an ellipsoid surface model, and distance to the center of the topographic map. Both presurgical and post-LASIK corneal topographies of 31 eyes were analyzed using monozone and multizone models. The patients were classified into three groups according to the different LASIK treatments applied: Allegretto, Zyoptix, and PlanoScan. For post-LASIK corneas, the multizone model provided a lower fit error, an average of 1.2+/-0.4 microm versus 2.4+/-0.7 microm (monozone). The comparative analysis of the three different LASIK treatments showed no improvement of custom over standard treatments. The outcomes of Zyoptix and PlanoScan were basically equivalent and consistent with previous findings: The higher-order aberration (HOA) increased by a factor of two. The increase in HOA was higher, by a factor of three, after the Allegretto treatment. The multizone model shows a higher-fidelity representation and permits a deeper understanding of the postsurgical cornea.