Wavefront-guided Excimer Laser Ablation Using Photorefractive Keratectomy and Sub-Bowman’s Keratomileusis: A Contralateral Eye Study

Abstract

To explain the basic science and clinical evidence that has led to the development of a new technique in corneal refractive surgery--sub-Bowman's keratomileusis (SBK). A comprehensive review of the literature and report of a contralateral eye study of 50 patients (100 eyes) enrolled at 2 sites (25 patients per site) and randomized according to the dominant eye was conducted. All eyes underwent a wavefront-guided refractive correction using the Alcon LADARVision4000 System. In one eye, an 8.5-mm, ETOH-assisted photorefractive keratectomy (PRK) was performed. In the second eye, an 8.5-mm, 100-microm flap was attempted using a 60 kHz IntraLase FS femtosecond laser. Pre- and postoperative tests included best spectacle-corrected visual acuity, uncorrected visual acuity, corneal topography, wavefront aberrometry, retinal image quality, contrast sensitivity, and biomechanical response of the cornea. Patients completed subjective questionnaires at each follow-up. Clinical results demonstrate that SBK provides quicker visual recovery, although the data suggest that the 3- and 6-months results are similar in terms of visual outcomes. Reichert Ocular Response Analyzer results demonstrate that its impact on the cornea is similar to PRK. This study indicates that SBK provides the visual recovery of a LASIK procedure with the Optical Response Analyzer results similar to PRK.