One-Year Outcomes From a Prospective, Randomized, Eye-to-Eye Comparison of Wavefront-Guided and Wavefront-Optimized...

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Myopia affects a significant portion of the population, leading to reduced visual acuity.
• Photorefractive keratectomy (PRK) is a common surgical procedure to correct refractive errors.
• Advancements in excimer laser technology offer wavefront-guided (WFG) and wavefront-optimized (WFO) approaches to PRK.

Purpose of the Study:

• To compare the efficacy of wavefront-guided (WFG) versus wavefront-optimized (WFO) photorefractive keratectomy (PRK).
• To evaluate objective and self-reported quality of vision outcomes in myopic patients undergoing PRK.
• To determine differences in visual acuity, higher-order aberrations, and patient satisfaction between WFG and WFO PRK.

Main Methods:

• A prospective randomized study involving 40 eyes from 20 myopic participants.
• Participants underwent either WFG or WFO PRK using the WaveLight Allegretto Eye-Q 400-Hz excimer laser.
• Outcomes assessed at 12 months included uncorrected and corrected distance visual acuity, contrast sensitivity, higher-order aberrations, and a validated quality of vision questionnaire.

Main Results:

• No statistically significant differences were observed between WFG and WFO PRK groups in refractive error outcomes, visual acuity (UDVA, CDVA), contrast sensitivity, or higher-order aberrations (HOAs).
• Patient-reported quality of vision parameters showed no significant differences between the two PRK methods at 12 months postoperatively.
• Both WFG and WFO PRK groups demonstrated significant improvements in subjective visual quality compared to preoperative values; 56.25% of patients had no preference between the two surgical methods.

Conclusions:

• Wavefront-guided (WFG) and wavefront-optimized (WFO) PRK yield similar objective and subjective visual outcomes in myopic patients.
• The Alcon Wave-Light Allegretto Eye-Q 400-Hz excimer laser platform provides comparable results for both WFG and WFO PRK techniques.
• Both approaches result in satisfactory visual quality and reduced visual symptoms at 12 months postoperatively.