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Denise Ryan, Rose Sia, Richard Stutzman, Joseph Pasternak, Lamarr Peppers, Jennifer Eaddy, Lorie Logan, Edward Trudo, Kraig Bower; Patient Satisfaction and Quality of Vision after Wavefront-guided (WFG) vs. Wavefront-optimized (WFO) Photorefractive keratectomy (PRK). Invest. Ophthalmol. Vis. Sci. 2013;54(15):3135.
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To compare higher order aberration (HOA) root mean square (RMS) and patient satisfaction of postoperative vision after WFG vs. WFO PRK.
Participants randomized to receive WFG PRK (VISX Star S4, Abbott Medical Optics) or WFO PRK (Wavelight Allegretto Wave Eye-Q, Alcon Surgical) underwent testing to determine their HOA RMS preoperatively and at 6 months (M) postoperatively. RMS HOA were analyzed at four different pupil sizes (4, 5, 6, and 7mm) using Complete Ophthalmic Analysis System (COAS, Abbott Medical Optics). A repeated measures analysis of variance (RM-ANOVA) was used to compare WFG vs. WFO PRK HOA RMS at each pupil size over time. Participants responded to a questionnaire preoperatively and 6M postoperatively. A Mann-Whitney test was used to compare patient satisfaction of postoperative vision. A p-value <0.05 was considered statistically significant.
PRK was performed on 26 WFG and 26 WFO participants. There were no significant differences in preoperative age or manifest spherical equivalent (MSE): Age: 30.0 ±7.0 years (y) WFG vs. 29.9 ±5.6y WFO, p=0.90; MSE: -3.49±1.88 Diopters (D) WFG vs. -3.33±1.79 WFO, p=0.66. MSE at 6M was 0.09±0.38 WFG vs. -0.02±0.31 WFO, p=0.09. Results of HOA RMS analysis at each pupil size, over time are presented in Figure 1. Comparing WFG vs. WFO over time at each pupil size p=0.04, 0.03, 0.08, 0.03 at 4mm, 5mm, 6mm, and 7mm respectively. Results from the questionnaire are presented in Table 1.
Results show there is a significant difference in RMS HOA when comparing WFG vs. WFO PRK over time. Although there was a significant increase in HOA RMS of WFO PRK patients postoperatively, questionnaire results showed no significant difference in daily activities, glare, halo or satisfaction with the procedure when comparing WFG vs. WFO PRK. Ongoing testing in this study will determine if either WFG or WFO generated optical quality affects military task performance.
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