Visual acuity and higher-order aberrations with wavefront-guided and wavefront-optimized laser in situ keratomileusis
Received 8 March 2009; received in revised form 31 August 2009; accepted 14 September 2009.
Purpose
To compare visual acuity and higher-order aberrations (HOAs) after wavefront-guided and wavefront-optimized laser in situ keratomileusis (LASIK).
Methods
This retrospective study comprised refraction-matched myopic eyes that had wavefront-guided (Visx Star S4 laser) or wavefront-optimized (WaveLight Allegretto Wave laser) LASIK targeted for emmetropia. Preoperative and postoperative manifest refraction spherical equivalent (MRSE), uncorrected (UDVA) and corrected (CDVA) distance visual acuities, and preoperative and postoperative HOAs were compared.
Results
Preoperatively, there were no significant differences between the wavefront-guided and wavefront-optimized groups in age, sex, corneal thickness, MRSE, or HOAs (all P>.05). The mean MRSE was −2.88 diopters (D) ± 2.6 (SD) and −2.96 ± 2.6 D, respectively, preoperatively and −0.01 ± 0.25 D and −0.02 ± 0.33 D, respectively, postoperatively; 96% of all eyes were within ±0.50 D of emmetropia postoperatively. There were no differences in UDVA, CDVA, MRSE, or HOAs between groups (all P>.05). The UDVA was 20/20 or better in 85% of eyes in the wavefront-guided group and 86% of eyes in the wavefront-optimized group. All eyes had 20/25 or better CDVA postoperatively; no eye lost 2 lines of CDVA. Fourteen eyes were converted from wavefront-guided to wavefront-optimized treatment because of poor limbal ring alignment (8 eyes), a wave scan not consistent with the manifest refraction (5 eyes), and no iris registration (1 eye).
Conclusions
Wavefront-guided LASIK and wavefront-optimized LASIK produced equivalent visual outcomes and no differences in HOAs. Wavefront-guided treatment could not be performed in many eyes because of difficulties during wavefront measurement.
Financial Disclosure
No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.
From Emory Vision, Atlanta, Georgia, USA
Corresponding author: J. Bradley Randleman, MD, 1365 B Clifton Road Northeast, Suite 4500, Atlanta, Georgia 30322, USA.
Additional financial disclosures: Dr. Stulting is a consultant to Alcon, Inc., and Abbott Medical Optics.
Supported in part by Research to Prevent Blindness, Inc. New York, New York, and the National Institutes of Health Core Grant P30 EYO6360, Bethesda, Maryland, USA.
ABSTRACT