Visual outcomes and higher-order aberrations of wavefront vs. combined wavefront aspheric

ABSTRACT

Objective@#We compared the efficacy, safety, refractive and visual outcomes, and aberrometry results of wavefront-guided aspheric treatment (WTA) versus wavefront-guided treatment (WT).@*Methods@#This prospective, contralateral, comparative study included 60 eyes of 30 patients who underwent myopic LASIK. One eye of each patient was randomized to either WTA or WT. Patients were followed up for 3 months postoperatively. Two-tailed paired t-test was used to determine statistical significance.@*Results@#At 3 months, 93% of eyes in the WTA group and 83% in the WT group had high-contrast uncorrected distance visual acuity (UDVA) of 20/20, while 87% in both groups achieved low-contrast UDVA of 20/40 or better. Sixty-four percent in the WTA gained 1 or more lines of low-contrast corrected distance visual acuity (CDVA) compared to 50% in the WT group. The mean sphere was 0.17D in the WTA and 0.14D in the WT (p = 0.63). The mean spherical equivalent was –0.04D for WTA and –0.03D for WT (p = 0.88). All eyes in both groups were within ±1.00D of the target emmetropia. The mean change in total higher-order aberration (HOA) was 0.07 μm in the WTA compared to 0.15 μm in the WT group (p = 0.04). The mean change in spherical aberration was –0.01 μm in the WTA and 0.18 μm in the WT group (p < 0.001). The mean change in Q value was significantly lower in the WTA (0.31) than in the WT group (0.63) (p < 0.001).@*Conclusion@#Wavefront aspheric LASIK (WTA) is a safe and effective treatment for myopic astigmatism. Refractive and visual outcomes were similar for both groups. WTA had less induction of higher-order aberration, lower spherical aberration, and better preservation of corneal asphericity (Q value). This translated to more lines of low-contrast vision gained compared to WT. Keywords LASIK, Wavefront-guided, Aspheric, Spherical aberration, higher-order aberration, Corneal curvature