Wavefront-optimized ablation versus topography-guided customized ablation in myopic LASIK: comparative study of higher order aberrations.

BACKGROUND AND OBJECTIVE: To compare the outcomes of wavefront-optimized ablation and topography-guided ablation in fellow eyes of patients undergoing laser in situ keratomileusis (LASIK) for myopia.

PATIENTS AND METHODS: This prospective study included 84 patients who underwent LASIK in both eyes: wavefront-optimized ablation in one eye (group I) and topography-guided ablation in the fellow eye (group II). The Moria2 microkeratome with a 110 single-use head (Moria, Antony, France) was used to create a superior hinged flap and the Allegretto Wave Excimer Laser (Alcon/Wavelight Light Laser Technologie GmbH, Erlangen, Germany) for photoablation. The Allegretto wave analyzer was used to measure the ocular aberrations before and 6 months after LASIK. Refractive visual outcomes and ocular aberration changes were compared between the two treatment modalities.

RESULTS: Six months postoperatively, the mean uncorrected visual acuity of group II was statistically better than that of group I (P = .02). Seventy percent of group I and 83% of group II achieved a postoperative spherical equivalent refraction of ±0.5 diopters. The postoperative total root-mean-square of higher order aberrations (HOAs) of group II was smaller than that of group I, but the difference was not statistically significant (P = .51). There was a decrease in most of the individual terms of HOAs in group II, but it was only statistically significant in Z(3) (-1) (P = .04). The reverse occurred in group I, where most of the individual terms of HOAs increased, but it was not statistically significant. Significant improvement was only noted in Z(5) (3) (P = .05) and Z(5) (5) (P = .04).

CONCLUSION: Both wavefront-optimized ablation and topography-guided ablation provided good refractive results, but the latter induced fewer HOAs.