Related Experiment Video
Updated: Mar 28, 2026
Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
Published on: September 16, 2025
Wavefront-guided versus wavefront-optimized photorefractive keratectomy: Clinical outcomes and patient satisfaction
Rose K Sia1, Denise S Ryan1, Richard D Stutzman1
1From the Warfighter Refractive Eye Surgery Program and Research Center at Fort Belvoir (Sia, Ryan, Eaddy, Logan), Fort Belvoir, Virginia, the Ophthalmology Service (Stutzman, Pasternak), Walter Reed National Military Medical Center, Bethesda, Maryland, the Ophthalmology Service (Torres), Madigan Army Medical Center, Tacoma, Washington, and the Wilmer Eye Institute (Bower), Johns Hopkins University, Baltimore, Maryland, USA.
Purpose:
To compare visual outcomes following Visx Star S4 Customvue wavefront-guided and Allegretto Wave Eye-Q 400 Hz wavefront-optimized photorefractive keratectomy (PRK).
Setting:
Warfighter Refractive Eye Surgery Program and Research Center, Fort Belvoir, Virginia, and Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Design:
Prospective randomized clinical trial.
Methods:
Active-duty United States military soldiers were randomized to have wavefront-guided (Visx Star S4 Customvue) or wavefront-optimized PRK. Participants were followed up to 12 months postoperatively. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and manifest spherical equivalent (SE). Secondary outcome measures included refractive astigmatism, higher-order aberrations (HOAs), contrast sensitivity, subjective visual complaints, and patient satisfaction.
Results:
The study evaluated 108 soldiers (mean age 30.3 years ± 6.3 [SD]; mean manifest SE -3.51 ± 1.63 D). At 12 months postoperatively, achieved UDVA, CDVA, manifest SE, and refractive astigmatism were comparable between wavefront-guided and wavefront-optimized groups (P > .213). Spherical aberration and total HOAs significantly increased from baseline in both groups (P < .006). The change in coma, trefoil, spherical aberration, and total HOAs (P > .254) were comparable between groups. There were fewer losses of photopic low-contrast visual acuity (LCVA) at 5% contrast after wavefront-guided compared to wavefront-optimized treatment (P = .003). There was no significant difference between treatment groups in visual symptoms, overall vision expectation, and satisfaction (P > .075).
Conclusion:
Wavefront-guided treatment offered a small advantage in photopic LCVA. Refractive outcomes, HOAs, self-reported visual difficulties, overall vision expectation, and satisfaction were otherwise comparable between wavefront-guided and wavefront-optimized treatments.
Financial Disclosure:
No author has a financial or proprietary interest in any material or method mentioned.
More Related Videos
05:46Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
Published on: September 20, 2024
07:29Three Different Protocols of Corneal Collagen Crosslinking in Keratoconus: Conventional, Accelerated and Iontophoresis
Published on: November 12, 2015
Related Concept Videos
01:28Angle Closure Glaucoma: Treatment
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...