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Richard Stutzman, Rose Kristine Sia, Denise S. Ryan, Tana Maurer, Christopher L Howell, Jennifer B Eaddy, Bruce A Rivers, Lamarr Peppers, Joseph F Pasternak, Kraig S Bower; The Effect of Wavefront-guided (WFG) and Wavefront-optimized (WFO) Photorefractive Keratectomy (PRK) on Subjective Quality of Vision (QOV) and Military Task Performance (MTP) among Active Duty U.S. Soldiers. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1523.
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To determine the effect of WFG and WFO PRK on soldiers’ self-reported QOV and the ability to detect and discriminate human and combat vehicle targets presented in infrared imagery.
In this prospective study, 27 myopic military personnel were randomized to undergo either WFG (n=14) or WFO PRK (n=13). Participants were asked to complete a questionnaire that focused on general satisfaction and QOV pre- and post-refractive surgery. MTP was evaluated preoperatively as well as 6 weeks and 6 months (M) postoperatively. In separate computer-based tasks, participants were asked to 1) search for human targets in a high clutter infrared scene; and 2) identify combat vehicle targets using thermal signatures. Change in probability of detection (Pd) and probability of identification (PID) at preop and 6M postop was assessed. Repeat measures analysis of variance and the Fisher exact test were performed to compare subjective QOV and MTP, respectively, between the two treatment groups. A p-value of <0.05 was considered significant.
There were no significant differences between WFG and WFO PRK for self-reported glare (p=0.94), halo (p=0.95) or visual difficulties in performing daily activities (p=0.27) over the 6M postop period. On a 10-point scale, one being the highest, overall expectation for vision was comparable at 6M postop (mean: 2.1 WFG, 1.7 WFO; p=0.36). There was no significant difference in patient satisfaction when participants were asked about the chance to have the procedure again (score: 1.1 WFG, 1.1 WFO; p=0.91). WFG and WFO PRK were comparable in MTP (p=0.99) at 6M postop. For human search, 8 of 10 WFG subjects scored equivalent to or better than preop Pd, while 2 subjects decreased Pd by more than 1 standard deviation (σ). Six of 7 WFO subjects scored equivalent to or better than preop Pd, while 1 subject decreased Pd by more than 1σ. For combat vehicle ID, 10 of 11 WFG subjects scored equivalent to or better than preop PID. Seven of 8 WFO subjects scored equivalent to or better than preop PID. One subject in each group decreased PID by more than 1σ.
Soldiers who underwent either WFG or WFO PRK were highly satisfied with their vision overall. Changes in MTP for human detection and vehicle ID were statistically equivalent between WFG and WFO PRK.
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