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Updated: Jun 29, 2026

Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile
Published on: September 20, 2024
Wavefront optimized versus custom-Q treatments in surface ablation for myopic astigmatism with the WaveLight
Aleksandar Stojanovic1, Ling Wang, Mirko R Jankov
1Eye Department, University Hospital of North Norway and SynsLaser Kirurgi, Tomsø, Norway. aleks@online.no
Purpose:
To compare treatments with wavefront optimized and custom-Q ablations.
Methods:
Two consecutive groups of eyes were treated for myopia and astigmatism with surface ablation. One group was treated with wavefront optimized ablation and the second group was treated with custom-Q ablation. Preoperative and 3-month postoperative Q-values, higher order aberrations, low contrast visual acuity, and classic outcome parameters were analyzed.
Results:
The wavefront optimized ablation group was comprised of 46 eyes of 23 patients with a mean spherical equivalent refraction (SE) of -3.64 diopters (D) (range: -1.15 to -8.25 D); mean Q-value changed from -0.33 preoperatively to 0.06 postoperatively. The custom-Q ablation group was comprised of 42 eyes of 21 patients with a mean SE of -3.24 D (range: -1.47 to -8.00 D); mean Q-value changed from -0.36 preoperatively to -0.03 postoperatively. A statistically significant difference in postoperative change in Q-values (P = .049) between the two groups was noted, but there was no such difference in higher order aberrations, low contrast visual acuity, or classic outcome parameters.
Conclusions:
Custom-Q ablation resulted in a mean postoperative asphericity that was closer to preoperative compared to wavefront optimized ablation, whereas the other outcome parameters showed no statistically significant differences.
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