Comparing corneal higher-order aberrations in corneal wavefront-guided transepithelial photorefractive keratectomy versus small-incision lenticule extraction

Abstract

To evaluate the changes in corneal higher-order aberrations (HOAs) after corneal wavefront-guided transepithelial photorefractive keratectomy (PRK) and small-incision lenticule extraction (SMILE). Yonsei University College of Medicine and Eyereum Eye Clinic, South Korea. Retrospective case series. Medical records of patients having either corneal wavefront-guided transepithelial PRK or small-incision lenticule extraction were examined. The root-mean-square total HOAs,3rd-order coma aberration, and 4th-order spherical aberration were measured preoperatively and 6months postoperatively. Independent t tests and analysis of covariance were used to compare changes in corneal HOAs between the 2 groups. The study comprised 77 eyes having corneal wavefront-guided transepithelial PRK and 81 eyes having small-incision lenticule extraction. The total HOAs and spherical aberration increased after transepithelial PRK (all P<.001), whereas coma aberration was stable after transepithelial PRK. The total HOAs, spherical aberration, and coma aberration increased after small-incision lenticule extraction (P<.001 for total HOAs, spherical aberration; P=.004 for coma). At 6months postoperatively, total HOAs and spherical aberration were significantly larger in the transepithelial PRK group than in the small-incision lenticule extraction group. Coma aberration was larger in the small-incision lenticule extraction group than in the transepithelial PRK group. Spherical aberration induction was significantly smaller in the small-incision lenticule extraction group than in the transepithelial PRK group (P<.001), and coma aberration induction was larger in the small-incision lenticule extraction group than in the transepithelial PRK group (P=.011). Small-incision lenticule extraction demonstrated that the induction of total HOAs was comparable to corneal wavefront-guided transepithelial PRK, accompanied by smaller spherical aberration induction and larger coma aberration induction. During small-incision lenticule extraction, surgeons should aim to obtain optimum centration for smaller induction of corneal HOAs.