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Prospective, randomized, contralateral eye comparison of high-resolution wavefront-guided and wavefront-optimized LASIK. American journal of ophthalmology Roe, J. R., Manche, E. E. 2019

Abstract

To compare outcomes in wavefront-optimized (WFO) laser in situ keratomileusis (LASIK) to high resolution wavefront-guided (WFG) LASIK.Randomized, fellow eye controlled, clinical trial METHODS: 200 eyes of 100 patients with myopia or compound myopic astigmatism undergoing bilateral LASIK between October 2015 and February 2017 underwent wavefront-optimized (WFO) in one eye and wavefront-guided (WFG) LASIK in fellow eye. Each eye was evaluated for uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, refractive error and wavefront aberrometry.Primary outcome was UDVA at 12 months. Secondary outcomes were safety, predictability, stability, refractive error, CDVA, contrast sensitivity and higher order aberrations at 12 months.WFG LASIK had higher levels of supervision and better contrast sensitivity when compared to WFO. Both had excellent postoperative UDVA results, without a significant difference in either mean UDVA or frequency of achieving a specified UDVA, for example 20/16 or better (all P > 0.05). The mean gain in lines of CDVA was significantly higher in the WFG compared to WFO group (0.80 ± 0.75 vs 0.62 ± 0.72; P = 0.04). The WFG cohort had significantly better contrast sensitivity for mean and frequency of achieving > 20/40 for <5% low contrast sensitivity (37.1%, 95% CI, 27.5 - 46.7 vs 24.7%, 95% CI, 16.2 - 33.3; P = 0.01) and >20/32 for <25% low contrast sensitivity (10.3%, 95% CI, 4.3 - 16.4 vs 4%, 95% CI, 0.0 - 8.1; P = 0.04). The WFO group had a significantly higher frequency of <0.25 diopters (D) of refractive astigmatism at 12 months (82.5%, CI 95%, 75.0 - 90.0 vs 72.1%, CI 95%, 63.2 - 81.2; P = 0.02), but not <0.50 D (95.6%, CI 95%, 91.9 - 99.8 vs 96.9, CI 95%, 93.5 - 100; P = 0.61). The WFG group was significantly closer to emmetropia for both sphere and spherical equivalent at all timepoints. Trefoil was significantly lower in the WFG group and was also significantly lower than preoperative measurements.Wavefront-optimized and high-resolution wavefront-guided LASIK achieve excellent visual outcomes. Nonetheless, treatments based on a high-resolution aberrometer appear to offer superior results in some regards.

View details for DOI 10.1016/j.ajo.2019.05.026

View details for PubMedID 31173739