Quality of Vision After Wavefront-Guided or Wavefront-Optimized LASIK: A Prospective Randomized Contralateral Eye...

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Laser-assisted in situ keratomileusis (LASIK) is a common refractive surgery procedure.
• Advancements in LASIK technology include wavefront-guided and wavefront-optimized ablation profiles.
• Comparing visual outcomes between different LASIK platforms is crucial for patient selection and satisfaction.

Purpose of the Study:

• To compare subjective visual quality after wavefront-guided LASIK (WG-LASIK) versus wavefront-optimized LASIK (WO-LASIK).
• To evaluate the impact of different excimer laser platforms on visual symptoms.
• To assess patient preference between WG-LASIK and WO-LASIK.

Main Methods:

• A randomized trial involving 55 myopic participants comparing WG-LASIK (VISX Star S4 IR) and WO-LASIK (WaveLight Allegretto Wave Eye-Q).
• Each participant received alternate treatments in their dominant and fellow eyes.
• Subjective visual quality and symptoms were assessed using questionnaires at multiple postoperative time points (1, 3, 6, and 12 months).

Main Results:

• No significant differences in individual visual symptoms were observed between WG-LASIK and WO-LASIK at 3, 6, and 12 months.
• At 12 months, WG-LASIK eyes showed a trend towards more excellent vision (P=.039).
• In patients with lower baseline higher-order aberrations (HOAs < 0.3 µm RMS), WO-LASIK was associated with trends of worsened nighttime clarity, daytime clarity, and fluctuating vision.

Conclusions:

• Most patients reported similar visual symptoms 12 months after WG-LASIK or WO-LASIK.
• A significant portion of patients (36%) preferred WG-LASIK over WO-LASIK (19%), with 45% having no preference.
• Preference for WG-LASIK was more pronounced in patients with lower baseline HOAs.