Visual differences in topography-guided versus wavefront-optimized LASIK in the treatment of myopia: a Meta-analysis

Area of Science:

• Ophthalmology
• Refractive Surgery
• Laser Vision Correction

Background:

• Laser in situ keratomileusis (LASIK) is a common procedure for myopia correction.
• Topography-guided (TG) and wavefront-optimized (WFO) LASIK represent distinct approaches to corneal ablation.
• Understanding the comparative outcomes of TG-LASIK and WFO-LASIK is crucial for patient selection and surgical planning.

Purpose of the Study:

• To compare the efficacy and safety of topography-guided (TG) versus wavefront-optimized (WFO) LASIK for myopia correction.
• To evaluate differences in visual acuity, refractive outcomes, and wavefront aberrations between the two LASIK techniques.

Main Methods:

• A systematic literature search was conducted across major scientific databases (PubMed, Cochrane, Web of Science, EMBASE, and Chinese databases) up to August 2020.
• Eleven studies involving 1425 eyes were included in the meta-analysis.
• Data on visual acuity, refractive status, and aberrations were analyzed using STATA software.

Main Results:

• No significant differences were found in achieving 20/20 or better uncorrected distance visual acuity (UCVA) or lines of vision gained between TG-LASIK and WFO-LASIK.
• TG-LASIK demonstrated a significantly higher proportion of eyes achieving postoperative refraction within ±0.5 diopters of target.
• TG-LASIK resulted in better UCVA, lower manifest refraction spherical equivalent (MRSE), and significantly reduced higher-order aberrations (HOAs), spherical aberration, and coma compared to WFO-LASIK.

Conclusions:

• Both TG-LASIK and WFO-LASIK are safe, effective, and predictable for myopia correction.
• TG-LASIK may offer advantages over WFO-LASIK by potentially producing fewer aberrations and greater refractive precision.
• Further research may elucidate long-term comparative outcomes and patient-reported visual quality.