Prospective, randomized, contralateral eye comparison of wavefront-guided and topography-guided LASIK.

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Laser-assisted in situ keratomileusis (LASIK) is a common procedure for correcting refractive errors.
• Advancements in LASIK technology include wavefront-guided (WF-guided) and topography-guided (TG) approaches.
• Comparing the visual outcomes of different LASIK planning methods is crucial for optimizing patient results.

Purpose of the Study:

• To compare the visual outcomes between ocular wavefront-guided (OWFG) LASIK and topography-guided (TG) LASIK.
• To evaluate refractive accuracy, visual acuity, and higher-order aberrations after both procedures.

Main Methods:

• A prospective, randomized, contralateral eye-controlled trial was conducted.
• Patients with myopia or compound myopic astigmatism received OWFG-LASIK in one eye and TG-LASIK in the fellow eye.
• Visual outcomes, including uncorrected and low-contrast visual acuity and aberrations, were assessed up to 12 months post-operation.

Main Results:

• No statistically significant differences were found in spherical equivalent, higher-order aberrations, or proportion of eyes achieving ≥20/20 uncorrected distance visual acuity (UDVA) between OWFG-LASIK and TG-LASIK at 12 months.
• A significantly greater percentage of eyes achieved UDVA of 20/12.5 with OWFG-LASIK compared to TG-LASIK (p = 0.003).
• Both methods demonstrated excellent predictability and clinical outcomes.

Conclusions:

• OWFG-LASIK and TG-LASIK yield similar refractive results and excellent clinical outcomes for myopia correction.
• Both approaches offer high predictability in achieving desired visual outcomes.
• OWFG-LASIK may offer an advantage in achieving superior uncorrected visual acuity.