Abstract
BackgroundTo compare the corneal high-order aberrations (HOAs), asphericity and regularity after Q-value guided laser in situ keratomileusis (LASIK) and laser epithelial keratomileusis (LASEK) in high myopic astigmatism.MethodsIn this retrospectively comparative study, we measured the corneal HOAs, asphericity indices (Q values) and corneal regularity indices preoperatively and 36 months postoperatively in 70 eyes (35 patients) with Q-value guided surgeries. All the patients with high myopic astigmatism were divided into two groups which included 34 eyes underwent LASIK and 36 eyes underwent LASEK procedures. The main impact factors of the high-order aberrations were also analyzed.ResultsIn the two groups, the efficacy index was more than 1.00 and safety index approached 1.00 at year 3 postoperatively. Statistically significant (P < 0.05) increased in Q values and main corneal HOAs (spherical aberrations and coma) following Q-value guided LASIK and LASEK procedures. Spherical aberrations increased more in the LASEK group and there was statistically difference compared to the LASIK group (P < 0.05). LASEK had better effects in correcting corneal astigmatism (P < 0.05). All the corneal regularity indices after surgeries increased and there was no significant difference (P = 0.707, P = 0.8 and P = 0.224, respectively) between the two groups. The main impact factors of spherical aberration included the optic zone size, changes of Q value, surgical procedure and the corrected refraction.ConclusionsIn high myopic astigmatism, Q-value guided ablation showed good safety, efficacy and predictability. Q value, regularity indices, spherical aberration and coma increased in both LASIK and LASEK procedures. Astigmatism could be corrected more effectively by LASEK but greater spherical aberration could be created. The difference might be related to the different healing mechanisms. Optic zone size and the corrected refraction might be the main influence factors on the anterior corneal high order aberrations.
Highlights
To compare the corneal high-order aberrations (HOAs), asphericity and regularity after Q-value guided laser in situ keratomileusis (LASIK) and laser epithelial keratomileusis (LASEK) in high myopic astigmatism
We reviewed the records of patients who underwent Q value guided refractive surgery at Shanghai Sixth People's Hospital during 2007 and who had a postoperative follow-up at year 3 after surgeries
Aspheric LASIK was performed on 34 eyes of 17 patients (8 eyes of 4 males, 26 eyes of 13 females), and aspheric LASEK was performed on 36 eyes of 18 patients (4 eyes of 2 males, 32 eyes of 16 females)
Summary
To compare the corneal high-order aberrations (HOAs), asphericity and regularity after Q-value guided laser in situ keratomileusis (LASIK) and laser epithelial keratomileusis (LASEK) in high myopic astigmatism. Laser in situ keratomileusis (LASIK) was reported clinically in 1990 [1] and was still a commonly performed surgery all over the world. Laser epithelial keratomileusis (LASEK), as a surface ablation technique, has gained popularity in recent years. In recent years, customized ablation surgery emerged to improve visual quality. Q value guided ablation, as one of the customized surgical procedures, has been reported clinically in recent years. The main goals of this study were to compare visual acuity, corneal high-order aberrations and changes in the anterior corneal surface between Q-value guided LASIK and LASEK
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