{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:06:31Z","timestamp":1790996791212,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001818","name":"Research to Prevent Blindness","doi-asserted-by":"publisher","award":["Unrestricted Grant"],"award-info":[{"award-number":["Unrestricted Grant"]}],"id":[{"id":"10.13039\/100001818","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Previous studies have demonstrated safety and efficacy using 6.0 and 6.5 mm optical zones in the WaveLight EX500 Excimer Laser System but have not evaluated if differing optical zone sizes influence refractive outcomes. This study examines visual outcomes between two study populations undergoing LASIK with either a 6.0 mm (1332 patients) or 6.5 mm (1332 patients) optical zone. Outcomes were further stratified by severity of myopia (low, moderate, and high) and astigmatism (low and high). Patients were matched by age and preoperative manifest sphere and cylinder. Postoperative measurements were then compared. The 6.5 mm group demonstrated better postoperative manifest refractive spherical equivalent (MRSE), manifest sphere, and absolute value of the difference in actual and target spherical equivalent refraction (|\u2206 SEQ|), within the total population, moderate myopia, and low astigmatism groups, but this did not lead to improved postoperative uncorrected distance visual acuity (UDVA) or best corrected distance visual acuity (CDVA). Though astigmatic correction and postoperative angle of error were similar between optical zone sizes, they were significantly worse with high myopia. Overall, this study demonstrates differences in visual outcomes between the 6.0 and 6.5 mm optical zone sizes that may warrant consideration; however, essentially, the results are comparable between them.<\/jats:p>","DOI":"10.3390\/jcm10173776","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T22:12:22Z","timestamp":1629843142000},"page":"3776","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of 6.0 mm versus 6.5 mm Optical Zone on Visual Outcomes after LASIK"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1024-6250","authenticated-orcid":false,"given":"Majid","family":"Moshirfar","sequence":"first","affiliation":[{"name":"Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA"},{"name":"John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84132, USA"},{"name":"Utah Lions Eye Bank, Murray, UT 84107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6473-1940","authenticated-orcid":false,"given":"Rachel","family":"Huynh","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine, Salt Lake City, UT 84132, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Bundogji","sequence":"additional","affiliation":[{"name":"University of Arizona College of Medicine Phoenix, Phoenix, AZ 85004, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyson N.","family":"Tukan","sequence":"additional","affiliation":[{"name":"University of Arizona College of Medicine Phoenix, Phoenix, AZ 85004, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Sant","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine, Salt Lake City, UT 84132, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6339-3628","authenticated-orcid":false,"given":"Shannon E.","family":"McCabe","sequence":"additional","affiliation":[{"name":"Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA"},{"name":"Mission Hills Eye Center, Pleasant Hill, CA 94523, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"William B.","family":"West","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine, Salt Lake City, UT 84132, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirk","family":"Drennan","sequence":"additional","affiliation":[{"name":"Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8852-4380","authenticated-orcid":false,"given":"Yasmyne C.","family":"Ronquillo","sequence":"additional","affiliation":[{"name":"Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip C.","family":"Hoopes","sequence":"additional","affiliation":[{"name":"Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/S0002-9394(14)71911-7","article-title":"Excimer laser surgery of the cornea","volume":"96","author":"Trokel","year":"1983","journal-title":"Am. J. Ophthalmol."},{"key":"ref_2","unstructured":"Peyman, G.A. (1989). Method for Modifying Corneal Curvature. (US4840175A), U.S. Patent."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1002\/lsm.1900100511","article-title":"Laser in situ keratomileusis","volume":"10","author":"Pallikaris","year":"1990","journal-title":"Lasers Surg. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1007\/s00417-009-1102-x","article-title":"Comparison of Different Excimer Laser Ablation Frequencies (50, 200, and 500 Hz)","volume":"247","author":"Khoramnia","year":"2009","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1001\/archopht.119.8.1159","article-title":"Effect of Larger Ablation Zone and Transition Zone on Corneal Optical Aberrations after Photorefractive Keratectomy","volume":"119","author":"Endl","year":"2001","journal-title":"Arch. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/S0886-3350(99)00144-3","article-title":"Excimer ablation design and elliptical transition zones","volume":"25","author":"MacRae","year":"1999","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"133","DOI":"10.3928\/1081-597X-20000301-05","article-title":"Role of the corneal epithelium in refractive changes following laser in situ keratomileusis for high myopia","volume":"16","author":"Spadea","year":"2000","journal-title":"J. Refract. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"92","DOI":"10.3341\/kjo.2016.30.2.92","article-title":"Factors Affecting Long\u2212term Myopic Regression after Laser In Situ Keratomileusis and Laser\u2212assisted Subepithelial Keratectomy for Moderate Myopia","volume":"30","author":"Lim","year":"2016","journal-title":"Korean J. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1016\/S0161-6420(02)01106-5","article-title":"Effect of Myopic Laser In Situ Keratomileusis on Epithelial and Stromal Thickness A Confocal Microscopy Study","volume":"109","author":"Erie","year":"2002","journal-title":"Ophthalmology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/S0002-9394(02)01942-6","article-title":"Mathematical model of corneal surface smoothing after laser refractive surgery","volume":"135","author":"Huang","year":"2003","journal-title":"Am. J. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1016\/j.ophtha.2006.06.030","article-title":"Effects of Ablation Diameter on Long\u2212term Refractive Stability and Corneal Transparency after Photorefractive Keratectomy","volume":"113","author":"Rajan","year":"2006","journal-title":"Ophthalmology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1016\/S0886-3350(96)80143-X","article-title":"Effect of optic zone size on the outcome of photorefractive keratectomy for myopia","volume":"22","author":"Kim","year":"1996","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3928\/1081-597X-20050301-07","article-title":"Effect of optical zone ablation diameter on LASIK\u2212induced higher order optical aberrations","volume":"21","author":"Mok","year":"2005","journal-title":"J. Refract. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"734","DOI":"10.3928\/1081597X-20131021-02","article-title":"Pupil size and LASIK: A review","volume":"29","author":"Myung","year":"2013","journal-title":"J. Refract. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e023877","DOI":"10.1136\/bmjopen-2018-023877","article-title":"Preoperative refraction, age and optical zone as predictors of optical and visual quality after advanced surface ablation in patients with high myopia: A cross-sectional study","volume":"8","author":"Zhou","year":"2018","journal-title":"BMJ Open"},{"key":"ref_16","unstructured":"SurgiVision\u00ae Refractive Consultants (2021, June 08). Summary of Safety and Effectiveness for a Premarket Approval Application (PMA P020050 SSED), Available online: https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf2\/P020050B.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.clae.2015.02.004","article-title":"Wavefront\u2212Optimized Laser In Situ Keratomileusis with the Allegretto Wave Eye\u2212Q excimer Laser and the FEMTO LDV Crystal Line Femtosecond Laser: 6 Month Visual and Refractive Results","volume":"38","author":"Ziaei","year":"2015","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_18","unstructured":"FDA (2021, June 06). List of FDA\u2212Approved Lasers for LASIK, Available online: https:\/\/www.fda.gov\/medical\u2212devices\/lasik\/list\u2212fda\u2212approved\u2212lasers\u2212lasik."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/j.jcrs.2010.01.033","article-title":"Effect of 3 excimer laser ablation frequencies (200 Hz, 500 Hz, 1000 Hz) on the cornea using a 1000 Hz scanning\u2212spot excimer laser","volume":"36","author":"Khoramnia","year":"2010","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_20","unstructured":"Alcon Laboratories, Inc. (2021, June 10). Summary of Safety and Effectiveness Data (PMA P020050\/S023 SSED), Available online: http:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf10\/P100034b.pdf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"831","DOI":"10.3928\/1081-597X-20041101-12","article-title":"Clinical Photoablation with a 500 Hz Scanning Spot Excimer Laser","volume":"20","author":"Iseli","year":"2004","journal-title":"J. Refrac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/j.jcrs.2018.07.027","article-title":"Pursuing perfection in intraocular lens calculations: IV. Rethinking astigmatism analysis for intraocular lens\u2212based surgery: Suggested terminology, analysis, and standards for outcome reports","volume":"44","author":"Abulafia","year":"2018","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"63","DOI":"10.2174\/1874364101812010063","article-title":"Outcomes of LASIK for Myopia or Myopic Astigmatism Correction with the FS200 Femtosecond Laser and EX500 Excimer Laser Platform","volume":"12","author":"Niparugs","year":"2018","journal-title":"Open Ophthalmol. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.2147\/OPTH.S110626","article-title":"Comparison of efficacy, safety, and predictability of laser in situ keratomileusis using two laser suites","volume":"10","author":"Meidani","year":"2016","journal-title":"Clin. Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1007\/s10103-020-02948-w","article-title":"Evaluation of the effect of optic zone diameter selection on high\u2212order aberrations in photorefractive keratectomy excimer laser treatment","volume":"35","author":"Ozulken","year":"2020","journal-title":"Lasers Med Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1016\/j.jcrs.2018.04.041","article-title":"Comparison of the effect of LASIK parameters on the percent tissue altered (1\u2212dimensional metric) versus percent volume altered (3\u2212dimensional metric)","volume":"44","author":"Gatinel","year":"2018","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"713","DOI":"10.2147\/OPTH.S51313","article-title":"Ectasia risk factors in refractive surgery","volume":"10","author":"Santhiago","year":"2016","journal-title":"Clin. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40662-020-00218-y","article-title":"Impact of ablation ratio on 5\u2212year postoperative posterior corneal stability after refractive surgery: SMILE and FS\u2212LASIK","volume":"7","author":"Li","year":"2020","journal-title":"Eye Vis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.ajo.2005.10.006","article-title":"The incidence and risk factors for developing dry eye after myopic LASIK","volume":"141","author":"Chen","year":"2006","journal-title":"Am. J. Ophthalmol."},{"key":"ref_30","first-page":"1980","article-title":"Superficial Punctate Keratopathy after LASIK","volume":"44","author":"Kay","year":"2003","journal-title":"J. Korean Ophthalmol. Soc."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/17\/3776\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:50:27Z","timestamp":1760165427000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/17\/3776"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,24]]},"references-count":30,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["jcm10173776"],"URL":"https:\/\/doi.org\/10.3390\/jcm10173776","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,24]]}}}