Comparative evaluation of wavefront-guided and aspheric LASIK in myopia with preoperative significant higher order aberrations

Session Details

Session Title: LASIK II

Session Date/Time: Tuesday 08/09/2015 | 14:00-16:00

Paper Time: 14:24

Venue: Room 10

First Author: : A.Garg INDIA

Co Author(s): :    J. Goyal   R. Arora                 

Abstract Details

Purpose:

To compare the visual outcome, higher order aberrations (RMS-HOA) and corneal asphericity (Q value) between Wavefront guided and Aspheric laser in situ keratomileusis (LASIK) in myopia with preoperative HOA more than 0.30 microns.

Setting:

Department of Refractive Surgery, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India

Methods:

This was a prospective randomised study of 59 eyes of 37 patients, aged above 20 years, having -2 to-8 Dioptres myopia, 0 to-2.5 dioptres astigmatism, and preoperative HOA above 0.30 microns. Twenty nine eyes underwent Wavefront-guided LASIK and 30 eyes underwent Aspheric LASIK on Technolas Zyoptix laser platform (Bausch & Lomb Surgical, Rochester, NY). Corneal flap was created using Zyoptix XP microkeratome. Eyes having preoperative central corneal thickness below 500 microns, residual stromal bed thickness below 275 microns, keratoconus and dry eyes were excluded. All subjects were followed up for 6 months. P value less than0.05 was considered statistically significant.

Results:

At 6 months postoperatively, Aspheric group had significantly better uncorrected (P=0.02) and best corrected visual acuity (P=0.02) than Wavefront group and had lower mean residual spherical error (P=0.002). Mean induced change in HOA (at 6 mm pupil) was 0.32 ± 0.21 microns after Aspheric LASIK and 0.24 ± 0.25 microns after Wavefront LASIK at 6 months, which was not significant (P=0.21). Aspheric LASIK induced significantly lesser change in spherical aberrations than Wavefront LASIK (P below 0.01). Change in Q value was significantly lesser in Aspheric LASIK than Wavefront LASIK (0.52 ± 0.29 and 0.91 ± 0.32 respectively) (P below 0.01).

Conclusions:

Both Aspheric and Wavefront LASIK showed excellent efficacy, safety and predictablitity. However, Aspheric LASIK produced a better visual outcome as compared to Wavefront-guided LASIK. Aspheric LASIK induced similar change in total HOA-RMS even when preoperative HOA was more than 0.30 microns. Aspheric LASIK induced significantly lesser spherical aberrations and maintained corneal asphericity better than Wavefront LASIK irrespective of high preoperative HOA. Financial Disclosure: None of the authors have any financial interests in the company of the LASIK equipment and investigations being used.

Financial Interest:

NONE