Wavefront aberration outcomes of LASIK for high myopia and high hyperopia

To determine the higher order aberrations at the corneal first surface after conventional LASIK for high myopia and high hyperopia.

This was a retrospective study using a convenience sample with subjects divided into five groups by level of refractive correction. Group 1 were normals, having no eye disease or previous surgery, but may have had refractive error. Group 2 had low myopia (-1.00 to -5.87 D), group 3 high myopia (> 6.00 D), group 4 low hyperopia (+1.00 to +3.87 D), and group 5 high hyperopia (> 4.00 D). LASIK was performed using a Technolas 217 laser. Corneal topography was taken with Orbscan II, and Placido data exported to VOLPro software v6.71. Wavefront aberrations were determined for a 6.0-mm pupil.

The study included 264 subjects-group 1 (normal), n=204; group 2 (low myopia), n=20; group 3 (high myopia), n=20; group 4 (low hyperopia), n=10; and group 5 (high hyperopia), n=10. The spherical equivalent refractive error corrected (mean +/-SD) was 0.00 +/- 0.00 D in group 1, -3.92 +/- 1.47 D in group 2, -9.53 +/- 2.06 D in group 3, +2.49 +/- 0.51 D in group 4, and +5.54 +/- 1.22 D in group 5. The total higher order root-mean-square (RMS) wavefront aberration was 0.38 +/- 0.07 microm in group 1, 0.69 +/- 0.22 microm in group 2, 1.36 +/- 1.79 microm in group 3, 0.64 +/- 0.34 microm in group 4, and 1.76 +/- 0.54 microm in group 5. Spherical aberration was 0.25 +/- 0.06 mcirom in group 1, 0.45 +/- 0.11 microm in group 2, 0.64 +/- 0.29 microm in group 3, -0.11 +/- 0.15 microm in group 4, and -0.56 +/- 0.22 microm in group 5. The refractive correction (Rx) was highly correlated to total higher order RMS for myopic correction higher order RMS = 0.38 - 0.07 Rx, R2=0.52, and for hyperopic correction higher order RMS = 0.18 + 0.28 Rx, R2 = 0.75.

Conventional LASIK increases all corneal higher order aberrations with induced aberrations increasing with the magnitude of refractive correction. High refractive corrections, both myopic (>6.00 D) and hyperopic (>5.00 D), can lead to very high levels of corneal higher order aberrations.