High-repetition-rate excimer laser systems require spot sequences with optimized temporal and spatial spot distribution to minimize the increase in ocular surface temperature. An ocular surface temperature increase will always occur depending on the amount of refractive correction, the type of ablation profile, the radiant exposure, and the repetition rate of the laser system.

The temporal and spatial distribution of the laser spots (scan sequence) during a corneal laser procedure affected the surface quality and maximum ablation depth of the ablation profile. Corneal laser surgery could theoretically benefit from smaller spot sizes and higher repetition rates. The temporal and spatial spot distributions are relevant to achieving these aims.

. Purpose:  To evaluate the safety, efficacy, predictability and stability of laser in situ keratomileusis (LASIK) with a 1000‐Hz scanning spot excimer laser (Concept System 1000; WaveLight GmbH, Erlangen, Germany). Methods:  LASIK was performed on twenty eyes with myopia or myopic astigmatism (mean spherical equivalent refraction: −3.97 ± 1.72 dioptres (D); mean cylinder: −0.84 ± 0.77 D) using a microkeratome for flap creation and the Concept System 1000 for photoablation. Patients were examined preoperatively as well as 1, 3 and 6 months after the treatment. Manifest sphere and cylinder, uncorrected (UCDVA) and best corrected (BCDVA) distance visual acuity, corneal topography and pachymetry were analysed. Results:  We observed no adverse events that might have been associated with the use of a repetition rate of 1000 Hz. All eyes maintained or had improved BCDVA at 6 months after treatment when compared to preoperative values. Six months after LASIK, UCDVA was 20/20 or better in 85% and 20/25 or better in 100% of the eyes. The spherical equivalent refraction was within ±0.50 D in 95% of the eyes at 6 months after surgery. The refraction stayed stable over time; 95% of the eyes changed <0.5 D postoperatively. Conclusion:  LASIK with the prototype 1000‐Hz excimer laser was safe, efficient and predictable. The postoperative refraction was stable over time. There were no specific clinical side‐effects that might be associated with the use of such a high repetition rate.

Higher-repetition-rate excimer lasers require increased radiant exposure. Further experimental studies should be performed to determine the relevance of spatial and temporal spot positioning, ablation-plume dynamics, and temperature increases during high-repetition-rate laser treatments.

No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.