Topography-guided versus wavefront-optimized laser in situ keratomileusis for myopia: Surgical outcomes

Abstract

To compare the outcomes of topography-guided and wavefront-optimized surgery in patients having laser insitu keratomileusis (LASIK) for myopia. Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, and BALGEUN-EYE21 Operation Center, Gwangju, South Korea. Prospective case study. Patients had topography-guided LASIK in 1 eye and wavefront-optimized LASIK in the contralateral eye using Contoura Vision software and the WaveLight EX500 excimer laser. Refractive and visual outcomes were analyzed 3months postoperatively. The study comprised 43 patients. In both groups, the postoperative uncorrected distance visual acuity (UDVA) was 0.0 logarithm of the minimum angle of resolution or better in 90.7% of eyes and the residual spherical equivalent (SE) refractive error was ±0.75 diopter (D) in 81.4% of eyes. The UDVA, residual SE refractive error, and astigmatism did not differ significantly between the 2 groups. There was significant induction of higher-order aberrations (HOAs) in both groups, although corneal coma and trefoil did not increase and ocular trefoil decreased significantly in the topography-guided group (P=.038). However, in the wavefront-optimized group, corneal coma and trefoil increased significantly (P<.001 and P=.046, respectively) and ocular trefoil did not change significantly. In addition, topography-guided LASIK induced significantly fewer corneal total HOAs (P<.001), coma (P<.001), and trefoil (P=.020) than wavefront-optimized LASIK. Although both topography-guided LASIK and wavefront-optimized LASIK safely and effectively achieved the predicted refractive and visual outcomes, topography-guided LASIK induced fewer HOAs and significantly decreased ocular trefoil, corneal total HOAs, and coma.