Wavefront-guided vs Wavefront-optimized LASIK: A Randomized Clinical Trial Comparing Contralateral Eyes

PURPOSE: To compare wavefront-guided and wavefront-optimized LASIK in patients with myopic astigmatism up to -7.00 diopters (D) sphere and 3.00 D cylinder. METHODS: In this prospective, comparative study, 41 patients had wavefront-guided LASIK in one eye and wavefront-optimized LASIK in the fellow eye. The LASIK flap was created with a Hansatome XP microkeratome (Bausch & Lomb). The ALLEGRETTO Concerto excimer laser (WaveLight Laser Technologie AG) was used for photoablation. Pupil centroid shift and cyclotorsion were not compensated in the wavefront-guided treatments. The ALLEGRETTO Wave analyzer was used to measure ocular wavefront aberrations, and the CSV-1000 instrument (VectorVision) was used to measure contrast sensitivity before and 1 and 3 months after LASIK. RESULTS: Preoperative mean spherical equivalent refraction was -4.25 +/- 1.19 D (range: -7.50 to -2.50 D) and -4.15 +/- 1.21 D (range: -7.13 to -1.75 D) in the wavefront-guided and wavefront-optimized groups, respectively. Three months postoperatively, 33 (89.2%) eyes in the wavefront-guided group and 31 (83.8%) eyes in the wavefront-optimized group had uncorrected distance visual acuity of 20/20. Higher order aberrations increased from 0.28 +/- 0.08 mu m (range: 0.13 to 0.48 mu m) and 0.26 +/- 0.08 mu m (range: 0.13 to 0.55 mu m) to 0.45 +/- 0.17 mu m (range: 0.18 to 0.71 mu m) and 0.45 +/- 0.16 mu m (range: 0.21 to 0.84 mu m) in the wavefront-guided and wavefront-optimized groups, respectively. Except for C6 trefoil (P=.006), all Zernike polynomials increased in both groups postoperatively with no statistical difference between groups in spherical aberration (P=.41), C7 coma (P=.67), C8 coma (P=.79), and trefoil (P=.82). Contrast sensitivity did not decrease in either group and no statistically significant differences between groups were noted. CONCLUSIONS: Higher order aberrations, especially spherical aberration, increasd approximately the same amount in both groups. [J Refract Surg. 2011; 27(4):245-250.] doi:10.3928/1081597X-20100812-02