Comparative clinical study of wavefront-guided laser in situ keratomileusis with versus without iris recognition for myopia or myopic astigmatism

Abstract

To explore the postoperative visual acuity results of wavefront-guided LASIK with iris recognition for myopia or myopic astigmatism and the changes of higher-order aberrations and contrast sensitivity function (CSF). Series of prospective case studies, 158 eyes (85 cases) of myopia or myopic astigmatism were divided into two groups: one group underwent wavefront-guided LASIK with iris recognition (iris recognition group); another group underwent wavefront-guided LASIK treatment without iris recognition through the limbus maring point (non-iris recognition group). To comparative analyze the postoperative visual acuity, residual refraction, the RMS of higher-order aberrations and CSF of two groups. There was no statistical significance difference between two groups of the average uncorrected visual acuity (t = 0.039, 0.058, 0.898; P = 0.844, 0.810, 0.343), best corrected visual acuity (t = 0.320, 0.440, 1.515; P = 0.572, 0.507, 0.218), and residual refraction [spherical equivalent (t = 0.027, 0.215, 0.238; P = 0.869, 0.643, 0.626), spherical (t = 0.145, 0.117, 0.038; P = 0.704, 0.732, 0.845) and cylinder (t = 1.676, 1.936, 0.334; P = 0.195, 0.164, 0.563)] at postoperative 10 days, 1 month and 3 month. The security index of iris recognition group at postoperative 3 month was 1.06 and non-iris recognition group was 1.03; the efficacy index of iris recognition group is 1.01 and non-iris recognition group was 1.00. Postoperative 3 month iris recognition group 93.83% eyes and non-iris recognition group of 90.91% eyes spherical equivalent within ± 0.50 D (χ(2) = 0.479, P = 0.489), iris recognition group of 98.77% eyes and non-iris recognition group of 97.40% eyes spherical equivalent within ± 1.00 D (Fisher test, P = 0.613). There was no significance difference between the two groups of security, efficacy and predictability. Non-iris recognition group postoperative 1 month and postoperative 3 months 3-order order aberrations root mean square value (RMS) higher than the iris recognition group increased (t = 3.414, -2.870; P = 0.027, 0.045), in particular of coma; the general higher-order aberrations (t = 0.386, 1.132; P = 0.719, 0.321), 4-order aberrations (t = 0.808, 2.720; P = 0.464, 0.063), and 5-order aberrations (t = 0.148, -1.717; P = 0.890, 0.161) show no statistically significant difference. Three months after surgery, two groups have recovered at all spatial frequencies of CSF, iris recognition group at 3.0 c/d (t = 3.209, P = 0.002) and 6.0 c/d (t = 2.997, P = 0.004) spatial frequencies of CSF under mesopic condition was better than non-iris recognition group, glare contrast sensitivity function (GCSF) for 3.0 c/d (t = 3.423, P = 0.001) and 6.0 c/d (t = 6.986, P = 0.000) spatial frequencies under mesopic condition and 1.5 c/d (t = 9.839, P = 0.000) and 3.0 c/d (t = 7.367, P = 0.000) spatial frequencies under photopic condition in iris recognition group were better than non-iris recognition group, there were no significant difference between two groups at the other spatial frequencies. Wavefront-guided LASIK with or without iris recognition both acquired better postoperative visual acuity, but in comparison with without iris recognition, wavefront-guided LASIK with iris recognition is efficient to reduce coma and enhance contrast sensitivity of postoperative.