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Updated: Apr 5, 2026

Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
Published on: September 20, 2024
Aspheric versus wavefront-guided photorefractive keratectomy: contralateral eye study
Siamak Zarei-Ghanavati1, Hamid Gharaee1, David Rex Hamilton1
1From the Cornea Research Center (Zarei-Ghanavati, Gharaee), Mashhad University of Medical Sciences, Mashhad, and the Eye Research Center (Abrishami), Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; the Laser Refractive Center (Hamilton, Sanchez), Jules Stein Eye Institute, School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Purpose:
To compare the refractive, visual, and aberrometric outcomes between wavefront-guided photorefractive keratectomy (PRK) and aspheric PRK in myopic patients.
Setting:
Khatam-al-Anbia Eye Hospital, Mashhad, Iran.
Design:
Prospective randomized clinical trial.
Methods:
One eye of each patient was randomly assigned to excimer laser wavefront-guided PRK (Zyoptix) and the other eye to excimer laser aspheric PRK (Technolas 217z). The preoperative and 3-month and 6-month postoperative refractive errors, visual acuity, contrast sensitivity, and higher-order aberrations (HOAs) were compared between the groups.
Results:
Ninety-six eyes (48 patients) were enrolled. At the last postoperative visit, there were no between-group differences in uncorrected distance visual acuity (UDVA) (P = .987) or corrected distance visual acuity (P = .416). The mean spherical equivalent was -0.076 diopter (D) ± 0.029 (SD) in the wavefront-guided group and -0.077 ± 0.075 D in the aspheric PRK group (P = .684). Postoperatively, the mean area under the log of contrast sensitivity function (AULCSF) with and without glare testing improved over preoperative values (both P < .001). There was no statistically significant between-group difference in the AULCSF with glare (P = .903) or without glare (P = .978). Total HOAs increased after PRK in both groups, although aspheric PRK induced fewer HOAs than wavefront-guided PRK (P = .04).
Conclusions:
Both PRK methods equally improved postoperative UDVA and contrast sensitivity. The HOAs increased after treatment with both methods; however, aspheric ablation induced statistically fewer HOAs than wavefront-guided ablation.
Financial Disclosure:
No author has a financial or proprietary interest in any material or method mentioned.
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