Abstract
Purpose:To evaluate the changes and predictability of higher order aberrations (HOAs) after personalized laser in situ keratomileusis (LASIK) and personalized photorefractive keratectomy (PRK) for simple myopia and compound myopic astigmatism.Methods:In this prospective cross-sectional study, 100 eyes were included. A total of 50 eyes underwent personalized LASIK and 50 eyes underwent personalized PRK. Preoperative and postoperative wavefront data were compared between the two groups. The influential factors and predictability of HOAs were also assessed.Result:Total HOA increased in the amount of 0.01 ± 0.14 μm for the 5 mm pupil (P = 0.55) and 0.08 ± 0.22 μm for the 6 mm pupil (P = 0.02) after PRK; however after LASIK the corresponding values for the 5 and 6 mm pupil sizes were 0.05 ± 0.12 and 0.15 ± 0.18 μm, respectively (P < 0. 001). Mean changes were not significantly different between the PRK and LASIK groups for both 5 and 6 mm pupil sizes (P = 0.21 and P = 0.13, respectively). Spherical aberration increased following LASIK more than following PRK (P < 0.001). Changes in the root mean square (RMS) of total HOA had a statistically significant negative correlation (P < 0.001) with its preoperative value. HOA and spherical aberration reduced in majority of eyes when the preoperative spherical equivalent refraction was low.Conclusion:For the 6mm pupil size, the total HOA increased following both personalized PRK and LASIK with no significant difference between the two groups. Change of the total HOA RMS was influenced by the preoperative values. The known influencing factors could predict nearly 50% of the changes in total HOA.
Highlights
Keratorefractive surgeries successfully reduce the spherocylindrical refractive errors, they may introduce a significant deterioration in the quality of vision
Our results demonstrated that the mean change of total higher order aberrations (HOAs) between wavefront‐guided photorefractive keratectomy (PRK) and wavefront‐guided laser in situ keratomileusis (LASIK) was not statistically significant for both pupil sizes each technique had different influences on Zernike coefficients
Our results were in contrast to a previous study by Moshirifar et al who showed that wavefront‐guided PRK induced fewer HOAs than wavefront‐guided LASIK.[22]
Summary
Keratorefractive surgeries successfully reduce the spherocylindrical refractive errors, they may introduce a significant deterioration in the quality of vision. An increase in the total higher order aberrations (HOA). Higher Order Aberrations after Wavefront‐guided LASIK and PRK; Hosseini et al has been reported after radial keratotomy,[1,2] laser in situ keratomileusis (LASIK),[3,4,5,6] and photorefractive keratectomy (PRK).[4,5,6,7] This increase in HOA after corneal refractive surgery is related to the pupil size; pupil dilation from 3.0 to 7.0 mm significantly increases the optical aberrations.[7] Many visual symptoms that patients experience postoperatively may be secondary to increase in the HOAs.[8,9,10]
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