Abstract
Purpose::
To compare the visual outcomes of the VISX WaveScan WaveFront System and the LADARWave CUSTOMCORNEA Wavefront System
Methods::
All custom advanced surface ablations (PRK and LASEK) done on the LADAR platform at Wilford Hall Medical Center from 3/05 through 9/06. The LADAR treatments will be compared with age, pre-op manifest spherical equivalent and cylinder matched patients treated on the VISX System during the same time period. Manifest and uncorrected visual acuities will be collected at the 1, 3, 6, and 12 month post-op.
Results::
226 eyes treated with the LADARWave CUSTOMCORNEA system. 266 age, pre-op manifest spherical equivalent and cylinder matched patients treated on the VISX were selected. The average age, pre-op manifest spherical equivalent and cylinder for the enrolled eyes are as follows: VISX- 31.2 years, -3.23 D, +0.6 D; LADAR- 31.0 years, -3.28 D, +0.56 D. At the time of submission there was the following follow-up data available (# of eyes, average post-op UCVA, manifest spherical equivalent and cylinder: VISX- 1 month- 142 eyes, 20/22.8, -0.29 D, +0.43 D, 3 month- 103 eyes, 20/17.4, -0.06 D, +0.18 D, 6 month- 70 eyes, 20/17.9, -0.04 D, +0.16 D, 12 month- 20 eyes, 20/17.8, -0.04 D, +0.14 D; LADAR- 1 month- 156 eyes, 20/22.3, -0.08 D, +0.41 D, 3 month- 108 eyes, 20/18.3, +0.11 D, +0.38 D, 6 month- 59 eyes, 20/17.3, +0.10 D, +0.18 D, 12 month- 25 eyes, 20/15.8, +0.05 D, +0.14 D. All data will be updated prior to presentation
Conclusions::
Patients treated on the LADAR system were significantly closer to plano at 1 month with an average post-op manifest spherical equivalent of -0.08 D compared to -0.29 D at 1 month on the VISX system. However, by 3 months and thereafter, patients treated on the LADAR system had an average post-op manifest spherical equivalent that was slightly hyperopic (+0.11 D, +0.10 D, and +0.05 D at 3, 6, and 12 months) whereas patients treated on the VISX system retained an average post-op manifest spherical equivalent that was just slightly myopic (-0.06 D, -0.04 D, and -0.04 D at 3, 6, and 12 months). Subgroup analysis also revealed that LASEK ablations completed with the LADAR platform had a significantly better average UCVA at 1 month than the VISX platform (20/20.7 versus 20/28.6). By 3 months and thereafter, this difference was no longer present. In conclusion, both laser platforms evaluated provided excellent post-operative visual outcomes. The VISX system achieved average manifest spherical equivalents near plano on the myopic side and the LADAR system did the same but on the hyperopic side. The LADAR system may provide faster visual recovery than the VISX system for LASEK treatments.