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Manoj Motwani Motwani LASIK Institute, San Diego, CA, 92121, USACorrespondence: Manoj MotwaniMotwani LASIK Institute, 4520 Executive Dr., Suite 230, San Diego, CA, 92121, USATel +1 858 554-0008Email drmmlj@gmail.com In response to the study performed by Brunson et al “Clinical Outcomes AfterTopography-guided Refractive Surgery in Eyes with Myopia and Astigmatism—Comparing Results with New Planning Software to Those Obtained Using theManifest Refraction,” there are significant issues with this study and the use ofthe Phorcides Analytic Engine that must be examined. 1Both manuscripts now published concerning outcomes from the PAE haveessentially followed the same script—focus on comparison to manifest refraction,comparing only visual results, no mention of axis variance from either manifest orContoura measured astigmatism, no mention of controls in picking patients forinclusion in the study, such as a consecutive series to prevent “cherry-picking,”small deviations in between magnitudes of manifest, Contoura measured, andPhorcides astigmatism, no topographic analysis to demonstrate that a more uniformcornea was being created, no analysis of Zernicke higher order aberration polynomialsto show that HOAs were reduced and not induced, no data concerningresidual astigmatism after treatment (except for a line stating no patient had greaterthan 0.5 D of residual astigmatism), no subjective patient outcomes, and noscientific explanation as to why Phorcides should be used and not simply theContoura measured astigmatism, which also analyses the higher order aberrationson the anterior corneal surface, which is the most important refracting element ofany optical system. 1,2View the original paper by Brunson and colleagues A Response to Letter has been published for this article. |
