Visual and Refractive Outcomes Across Low, Medium, and Large Cyclorotation Angles in Myopic LASIK With Automated Cyclorotation Compensation.

PURPOSE: To evaluate visual and refractive outcomes across different cyclorotation magnitudes in myopic laser in situ keratomileusis (LASIK) using automated cyclorotation compensation. METHODS: This retrospective comparative study included consecutive patients who underwent myopic LASIK between 2012 and 2023. Patients were divided into three groups according to their cyclorotation angle magnitude. A comparison of baseline and intraoperative parameters was performed. Refractive and visual outcomes were assessed, including efficacy and safety indices, and an Alpins vector analysis was performed. Multiple linear regression was used to identify the effect of potential confounders. RESULTS: Overall, 6,920 eyes of 4,454 patients were included. The mean age was 30.7 ± 8.7 years and 47.7% (2,130) were women. Analysis indicated significant differences in corrected distance visual acuity between the groups, but post-hoc analysis revealed no significant pairwise differences. Other visual and refractive outcomes including the calculated indices showed no significant differences. Alpins vector analysis showed no significant differences between the groups in any of the vectors in either magnitude or direction, nor were there significant differences in the calculated indicators. Multiple linear regression suggested age, maximum ablation depth, rotation direction, preoperative axis, and treated axis had confounding effects mostly on Alpins vectors. However, no significant effect was noted for outcomes that showed significant differences. CONCLUSIONS: Cyclorotational angle magnitude did not significantly impact visual or refractive outcomes in myopic LASIK when using modern laser devices. These findings suggest limited clinical relevance of cyclorotation degrees in LASIK outcomes, with other factors potentially playing a more significant role in surgical planning.