Outcomes of topography-guided versus wavefront-optimized laser in situ keratomileusis for myopia in virgin eyes

Abstract

To compare the outcomes of topography-guided and wavefront-optimized treatment in patients having laser in situ keratomileusis (LASIK) for myopia. Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Prospective contralateral-eye case study. Patients had topography-guided LASIK in 1 eye and wavefront-optimized LASIK in the contralateral eye using the Customized Refractive Surgery Master software and Mel 80 excimer laser. Refractive (residual manifest refraction spherical equivalent [MRSE], higher-order aberrations [HOAs]), and visual (uncorrected distance visual acuity [UDVA] and photopic and mesopic contrast sensitivity) outcomes were prospectively analyzed 6months postoperatively. The study comprised 35 patients. The UDVA was 0.0 logMAR or better and the postoperative residual MRSE was ±0.50 diopter in 94.29% of eyes in the topography-guided group and 85.71% of eyes in the wavefront-optimized group (P=.09). More eyes in the topography-guided group than in the wavefront-optimized group had a UDVA of -0.1 logMAR or better (P=.04).Topography-guided LASIK was associated with less deterioration of mesopic contrast sensitivity at higher spatial frequencies (12 cycles per degree [cpd] and 18 cpd) and lower amounts of induced coma (P=.04) and spherical aberration (P=.04). Less stromal tissue was ablated in the topography-guided group (mean 61.57μm±16.23 [SD]) than in the wavefront-optimized group (mean 79.71±14.81μm)(P<.001). Although topography-guided LASIK and wavefront-optimized LASIK gave excellent results, topography-guided LASIK was associated with better contrast sensitivity, lower induction of HOAs, and a smaller amount of tissue ablation. None of the authors has a financial or proprietary interest in any material or method mentioned.