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

To compare the visual outcomes of eyes treated with ocular wavefront-guided (OWFG) LASIK vs topography-guided (TG) LASIK.

Byers Eye Institute at Stanford University, Stanford, California.

Prospective, randomized, contralateral eye-controlled trial. Treatments were randomized according to ocular dominance.

This study treated patients with myopia or compound myopic astigmatism with OWFG-LASIK (planned using the iDesign Advanced WaveScan Studio System aberrometer) in 1 eye and TG-LASIK (planned using the Contoura Vision and WaveLight Topolyzer Vario) in the fellow eye from January 2023 to April 2024. Postoperative evaluation was performed at 1, 3, 6, and 12 months postoperatively and consisted of visual acuity, manifest refraction, 5% and 25% low-contrast visual acuity, and higher-order aberrations (HOAs) (coma, trefoil, and spherical aberration).

100 eyes of 50 patients with myopia or compound myopic astigmatism were enrolled in the study and underwent successful treatments. 96 eyes of 48 patients completed 12 months of follow-up. At postoperative month 12, there were no statistically significant differences between the OWFG-LASIK and TG-LASIK groups for spherical equivalent ( P > .05); HOAs, including coma, trefoil, and spherical aberrations ( P > .05); proportion of eyes that had ≥20/20 uncorrected distance visual acuity (UDVA) (100% in the OWFG-LASIK group vs 98% in the TG-LASIK group); or proportion of eyes that had improved 5% and 25% low-contrast visual acuity. Eyes randomized to OWFG-LASIK had a significant greater percentage of eyes achieving UDVA of 20/12.5 compared with TG-LASIK ( P = .003).

OWFG LASIK and TG LASIK achieve similar refractive results with excellent clinical outcomes and excellent predictability in both groups.