Abstract
BackgroundTo compare the clinical outcomes of wavefront-optimized (WFO) transepithelial photorefractive keratectomy (trans-PRK) and corneal wavefront-guided (CWFG) trans-PRK for myopic eyes with moderate to high astigmatism.MethodsOne hundred ninety-six eyes (196 patients) with moderate to high astigmatism (≥ 1.75 D) treated with WFO or CWFG trans-PRK (101 and 95 eyes, respectively) were retrospectively registered. Safety, efficacy, predictability, vector analysis, and corneal aberrations were compared between groups preoperatively and at 6 months postoperatively.ResultsAt postoperative 6 months, the mean logMAR uncorrected distance visual acuity was similar in the WFO (− 0.07 ± 0.08) and CWFG (− 0.07 ± 0.07) groups. Safety, efficacy, and predictability of refractive and visual outcomes were also similar. The correction indices were 1.02 ± 0.14 and 1.03 ± 0.13 in the WFO and CWFG groups, respectively, with no significant difference. The absolute values of the angle of error were significantly higher in the WFO group (2.28 ± 2.44 vs. 1.40 ± 1.40; P = 0.002). Corneal total root mean square higher-order aberrations and corneal spherical aberrations increased postoperatively in both groups; however, the change was smaller in the CWFG group. Corneal coma showed a significant increase postoperatively only in the WFO group.ConclusionsWFO and CWFG trans-PRK are safe and effective for correcting moderate to high astigmatism. However, CWFG trans-PRK provides a more predictable astigmatism correction axis and fewer induced corneal aberrations.
Highlights
To compare the clinical outcomes of wavefront-optimized (WFO) transepithelial photorefractive keratectomy and corneal wavefront-guided (CWFG) trans-PRK for myopic eyes with moderate to high astigmatism
A study that compared WFO and corneal WFG (CWFG) trans-PRK showed that both modalities are excellent and safe for correction of myopia, while CWFG trans-PRK has some advantages in postoperative HOAs over the WFO profile [1]
The total ablation zone and the maximum ablation depth were significantly smaller in the WFO group compared to that in the CWFG group, despite the comparable optical zones
Summary
To compare the clinical outcomes of wavefront-optimized (WFO) transepithelial photorefractive keratectomy (trans-PRK) and corneal wavefront-guided (CWFG) trans-PRK for myopic eyes with moderate to high astigmatism. Trans-PRK was a two-step surgery in which the corneal epithelium was removed first and the stroma was ablated; it was not widely used due to longer operating times, higher pain scores, and a deficiency of adequate nomograms [2]. Wavefront-optimized (WFO) and wavefront-guided (WFG), are widely employed to reduce the postoperative induction of HOAs [7, 8]. Numerous studies have compared the clinical outcomes in WFO and WFG treatments [6, 7, 9] Both profiles reduced HOAs and glare symptoms, and increased mesopic contrast sensitivity and patient preference [6, 10,11,12,13]. A study that compared WFO and corneal WFG (CWFG) trans-PRK showed that both modalities are excellent and safe for correction of myopia, while CWFG trans-PRK has some advantages in postoperative HOAs over the WFO profile [1]
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