Comparative analysis of outcomes after wavefront-guided and wavefront-optimized laser in-situ keratomileusis in high myopic eyes

Abstract

Purpose The aim was to evaluate and compare the clinical outcomes after laser in-situ keratomileusis (LASIK) in high myopia using wavefront-guided (WFG) and wavefront-optimized (WFO) ablation profiles provided by two different excimer laser platforms. Patients and methods Prospective, consecutive, comparative, and masked clinical trial including 41 high myopic eyes treated with WFG LASIK using the Advanced CustomVue system (WFG group) and 40 eyes treated with a WFO profile using the Allegretto EX-500 platform (WFO group). Visual, refractive, contrast sensitivity (CVS-1000), and aberrometric outcomes were evaluated in both groups of eyes during a 6-month follow-up. Results The efficacy index was significantly better in the WFG group compared with the WFO (1.01±0.11 vs. 0.96±0.12, P=0.038). The safety index was also significantly better in the WFG group (1.03±0.12 vs. 0.94±0.11, P=0.011). All eyes achieved postoperatively an uncorrected distance visual acuity of 20/25 or better in the WFG group, whereas 87.5% of eyes achieved this uncorrected distance visual acuity in the WFO group. More eyes gained one line of corrected distance visual acuity in the WFG group (36.5 vs. 15.0%, P=0.015). Significantly lower postoperative manifest refraction spherical equivalent (P=0.045) and cylinder (P=0.005) were found in the WFG group. Manifest refraction spherical equivalent was within ±1.00 D in 90.3% and 80% of eyes in WFG and WFO groups, respectively (P=0.001). Contrast sensitivity decreased significantly only in the WFO group (P≤0.0397). More significant increase in high-order aberrations was found in the WFO group (P≤0.005). Conclusion WFG LASIK provides better efficacy, safety, predictability, and preservation of visual quality in high myopic eyes than WFO LASIK.