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D.E. Setlik, K.L. Fry, P.S. Hersh; Comparison of Visual Outcomes of Wavefront Guided and Conventional LASIK . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4375.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare visual outcomes between eyes treated using conventional and custom LASIK. Methods: A retrospective chart review of 271 eyes (166 patients) treated for myopia and/or astigmatism was performed using the LADARVision excimer laser. One hundred and eighty eyes (108 patients) were treated with conventional LASIK and 91 eyes (58 patients) with the LADARWave CustomCornea System. Outcome variables included UCVA, BCVA, predictability, and wavefront aberrations (6.0mm pupil). Preoperative and 3–month follow–up data (mean 110 days) were analyzed. Patients in both groups were matched for age, preoperative manifest refraction spherical equivalent (MRSE) (up to 6.25D) and astigmatism (up to 1.0D). Mean MRSE of conventional eyes was –3.69 ± 1.48 D and –3.42 ± 1.46D for custom treated eyes. Results: There was not a statistically significant difference in mean postoperative UCVA between groups. Mean UCVA was 20/24 in custom and 20/26 in conventionally–treated eyes, respectively. However, custom eyes were more likely to reach 20/20 UCVA; 60 custom eyes (66%) achieved ≥ 20/20 compared to 96 conventional eyes (53%) (p=0.047). Difference in BCVA between groups did not meet statistical significance; mean pre– and postoperative BCVA was 20/20 for both groups. Mean predictability for custom ablations was –0.33 ± 0.47 D and for conventional ablations was –0.32 ± 0.47 D. Sixty eyes (66%) treated with custom LASIK were within ±0.50 D of attempted correction compared with 122 eyes (71%) treated with conventional ablation (p>0.05). However, no statistical significance differences in predictability were found. Comparison of pre– and postoperative wavefront error showed that both procedures induced significant amounts of coma, spherical aberration, other and total aberrations. However, only 16% of custom ablations compared with 38% of conventional treatments induced ≥0.50 microns of RMS of total higher order aberrations (p=0.02). Conclusions: Both conventional and custom LASIK produce similar visual outcomes. However, eyes treated with custom LASIK were more likely to achieve 20/20 uncorrected vision and less likely to have induced wavefront aberrations after surgery.
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