Contralateral Comparison of Alcon CustomCornea and VISX CustomVue Wavefront-guided Laser in situ Keratomileusis: One-month Results

Abstract

To evaluate the differences in outcomes between CustomCornea and CustomVue LASIK treatments on different eyes of the same patient 1 month after surgery. Thirty-five patients were enrolled in two phases of a prospective study and treated with Alcon CustomCornea LASIK (Alcon Laboratories Inc, Fort Worth, Tex) on one eye and VISX CustomVue LASIK (VISX, Santa Clara, Calif) on the fellow eye. Twenty-five patients were treated in phase I without nomogram adjustments and ten patients were treated in phase II with nomogram adjustments made to the VISX CustomVue treatments only. Standard clinical outcomes such as visual acuity and manifest refraction were evaluated as well as quality of vision measures such as subjective questionnaires, contrast sensitivity, and higher order optical aberrations. In the phase I group, 92% of the CustomCornea eyes and 72% of the CustomVue eyes were within 0.50 diopters (D) of their attempted correction. In the phase II group, with a nomogram applied to the CustomVue eyes, 80% of the CustomCornea eyes and 100% of the CustomVue eyes were within 0.50 D of their attempted correction. There was no loss of 22 lines of best spectacle-corrected acuity for the CustomCornea or CustomVue eyes in either phase I or phase II. Wavefront analysis demonstrated that the CustomVue eyes had statistically significantly more spherical aberrations at 1 month compared to the CustomCornea eyes in the phase I and II groups. An average increase in mesopic contrast sensitivity at spatial frequencies was seen for the CustomCornea eyes in phase II and in only one spatial frequency for the CustomVue eyes in phase II. At 1 month after LASIK, the CustomCornea eyes showed superiority in the number of eyes seeing 20/20 or better uncorrected visual acuity, constrast sensitivity at 3 and 12 cpd, and the amount of postoperative spherical aberration. After nomogram adjustment, CustomVue eyes had a more accurate refractive outcome. Patients were satisfied or extremely satisfied with both systems, 92%-100%.