Topography-guided versus wavefront-optimized laser in situ keratomileusis for myopia: Surgical outcomes

Purpose: To compare the outcomes of topography-guided and wavefront-optimized surgery in patients having laser in situ keratomileusis (LASIK) for myopia. Setting: Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, and BALGEUN-EYE21 Operation Center, Gwangju, South Korea. Design: Prospective case study. Methods: Patients had topography-guided LASIK in 1 eye and wavefront-optimized LASIK in the contralateral eye using Contoura Vision software and the WaveLight EX500 excimer laser. Refractive and visual outcomes were analyzed 3 months postoperatively. Results: The study comprised 43 patients. In both groups, the postoperative uncorrected distance visual acuity (UDVA) was 0.0 logarithm of the minimum angle of resolution or better in 90.7% of eyes and the residual spherical equivalent (SE) refractive error was ±0.75 diopter (D) in 81.4% of eyes. The UDVA, residual SE refractive error, and astigmatism did not differ significantly between the 2 groups. There was significant induction of higher-order aberrations (HOAs) in both groups, although corneal coma and trefoil did not increase and ocular trefoil decreased significantly in the topography-guided group (P = .038). However, in the wavefront-optimized group, corneal coma and trefoil increased significantly (P < .001 and P = .046, respectively) and ocular trefoil did not change significantly. In addition, topography-guided LASIK induced significantly fewer corneal total HOAs (P < .001), coma (P < .001), and trefoil (P = .020) than wavefront-optimized LASIK. Conclusion: Although both topography-guided LASIK and wavefront-optimized LASIK safely and effectively achieved the predicted refractive and visual outcomes, topography-guided LASIK induced fewer HOAs and significantly decreased ocular trefoil, corneal total HOAs, and coma.