Comparison of visual performance between conventional LASIK and wavefront-guided LASIK with iris-registration

Area of Science:

• Ophthalmology
• Refractive Surgery
• Optometry

Background:

• Laser in situ keratomileusis (LASIK) is a common refractive error correction procedure.
• Wavefront-guided LASIK aims to enhance postoperative visual quality through customized treatment.
• This study compares wavefront-guided LASIK with iris-registration to conventional LASIK.

Purpose of the Study:

• To compare visual acuity, higher-order aberrations, and contrast sensitivity between wavefront-guided LASIK and conventional LASIK.
• To evaluate the efficacy of wavefront-guided LASIK with iris-registration for specific patient groups.

Main Methods:

• A prospective study involving 211 myopic eyes (109 patients) randomly assigned to wavefront-guided LASIK (wg LASIK) or conventional LASIK groups.
• Wavefront analysis (Zernike coefficients, RMS of higher-order aberrations) and contrast sensitivity (CS) measurements were performed pre- and post-surgery.
• Measurements utilized a Wavescan Wavefront aberrometer and an Optec 6500 visual function instrument.

Main Results:

• The wg LASIK group showed significantly better uncorrected visual acuity (UCVA) and spherical equivalent (SE) at 3 months post-surgery.
• Wavefront-guided LASIK resulted in a statistically smaller increase in specific higher-order aberrations (Zernike coefficients) compared to conventional LASIK.
• The wg LASIK group demonstrated improved contrast sensitivity across all spatial frequencies, with and without glare, unlike the conventional LASIK group.

Conclusions:

• Wavefront-guided LASIK with iris-registration effectively reduces higher-order aberrations (spherical and coma) and enhances visual acuity and contrast sensitivity.
• This technique is particularly advantageous for patients with high preoperative higher-order aberrations (RMSh) and high preoperative astigmatism.