Abstract
BackgroundTo compare the outcomes of myopia and myopic astigmatism corrected with topography-modified refraction laser in situ keratomileusis (TMR-LASIK), wavefront-optimized (WFO) LASIK, and topography-guided (TG) LASIK with a correction target based on the manifest refraction (manifest TG-LASIK).MethodsThis observational, retrospective cohort study included patients who underwent LASIK using the WaveLight® EX500 excimer laser to correct myopia and myopic astigmatism between August 2016 and July 2017. Patients who underwent TMR-LASIK (85 patients), WFO-LASIK (70 patients), or manifest TG-LASIK (40 patients) were enrolled, and only one eye from each patient was analyzed. All participants underwent measurement of the uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BCVA), manifest refraction, vector analysis of astigmatic change, corneal topography, and corneal wavefront analysis at baseline and at every posttreatment visit.ResultsThree months postoperatively, a UDVA of 0.0 logMAR or better and manifest refraction spherical equivalent (MRSE) within ±0.5 diopters (D) did not differ across the TMR-, WFO-, and manifest TG-LASIK groups. However, the residual cylinder in the TMR group was significantly larger than that in the WFO and manifest TG groups. The magnitude of error in the TMR group measured using astigmatism vector analysis was significantly higher than that in the WFO and manifest TG groups.ConclusionsAlthough these three LASIK platforms achieved the predicted surgical outcomes, TMR-LASIK overcorrected astigmatism and showed a higher residual postoperative astigmatism compared with WFO- and manifest TG-LASIK.
Highlights
To compare the outcomes of myopia and myopic astigmatism corrected with topography-modified refraction laser in situ keratomileusis (TMR-Laser in situ keratomileusis (LASIK)), wavefront-optimized (WFO) LASIK, and topography-guided (TG) LASIK with a correction target based on the manifest refraction
A topographic adjustment was applied relative to the amount and axis of astigmatism, and TMRLASIK showed better visual and refractive outcomes compared with TG-LASIK with a correction target based on the manifest refraction [6]
A uncorrected distance visual acuity (UDVA) of 20/20 or better was measured at 3 months after surgery in 85.7% of eyes in the WFO group, 90.0% of eyes in the manifest TG group, and 80.0% of eyes in the TMR group (P = .781; Figs. 1, 2, and 3a)
Summary
To compare the outcomes of myopia and myopic astigmatism corrected with topography-modified refraction laser in situ keratomileusis (TMR-LASIK), wavefront-optimized (WFO) LASIK, and topography-guided (TG) LASIK with a correction target based on the manifest refraction (manifest TG-LASIK). Customized refractive surgery based on corneal topography has been widely used to correct myopia, astigmatism, and higher-order aberrations (HOAs). It has shown satisfactory surgical outcomes and common postlaser in situ keratomileusis (LASIK) symptoms including light sensitivity, glare, and halos [1, 2]. A topographic adjustment was applied relative to the amount and axis of astigmatism, and TMRLASIK showed better visual and refractive outcomes compared with TG-LASIK with a correction target based on the manifest refraction (manifest TG-LASIK) [6]. The primary purpose of this study was to evaluate whether TMR-LASIK overcorrected astigmatism and to compare surgical outcomes following surgery with TMR-, WFO-, and manifest TG-LASIK
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