Visual Acuity and Quality of Life Results in a Randomized Trial of Topography-Guided LASIK With GIS Software Versus...

To compare visual and refractive outcomes and patient-reported visual quality of life between topography-guided laser in situ keratomileusis with novel geographic imaging system (TG-GIS LASIK)-based software versus wavefront-optimized (WFO) LASIK.

This was a prospective, multi-site, randomized, clinical trial. Patients with bilateral myopic LASIK were randomized 1:1 to undergo bilateral TG-GIS LASIK or WFO LASIK using the Wavelight EX500 laser (Alcon Laboratories, Inc). The main outcome measure was the percentage of patients with monocular uncorrected distance visual acuity (UDVA) of 20/16 or better at 3 months. The Patient Reported Outcome With LASIK questionnaire was administered preoperatively and 3 months postoperatively.

One hundred seventeen patients (234 eyes) were enrolled. For monocular UDVA, 29% in the WFO LASIK group achieved 20/12.5 and 74.6% achieved 20/16 or better versus 18% (P = .05) and 67% of the TG-GIS LASIK group, respectively (P = .29). For mean refractive spherical equivalent, the percentage of eyes within ±0.50 diopters (D) of plano was 97% in the WFO LASIK group and 91% in the TG-GIS LASIK group (P = .09). The WFO LASIK group had 14% of eyes gain two lines of corrected distance visual acuity versus 7% (P = .09) in the TG-GIS LASIK group. Overall satisfaction was similar between groups (93.66, 91.77, P = .18) but there was increased satisfaction as it relates to magnitude of starbursts in the TG-GIS LASIK group (85.74 TG-GIS LASIK group, 81.62 WFO LASIK group, P = .03).

WFO LASIK trended toward higher rates of 20/12.5 UDVA but achieved similar rates of 20/16 UDVA and slightly superior refractive outcomes compared to TG-GIS LASIK. Overall, visual and refractive outcomes were favorable in both groups. Both groups had high patient satisfaction. [J Refract Surg. 2025;41(7):e625-e634.].