Comparison of Induced Simulated Keratometric Changes After Wavefront-Guided and Wavefront-Optimized LASIK

Tuesday, April 21, 2015: 1:26 PM
Room 1B (San Diego Convention Center)
Daniel Youngjun Choi, MD
Edward E. Manche, MD

To investigate the induced simulated keratometric (sim-K) changes after wavefront-guided (WG) and wavefront-optimized (WO) laser in situ keratomileusis (LASIK).

A prospective, randomized comparison study of fellow eyes that underwent WG-LASIK and WO-LASIK.  Preoperative and one year postoperative sim-K and spherical equivalents (SE) were recorded and modeled with regression analysis.

The mean of the ratio between changes in sim-K and SE was 0.94+0.80 and 0.86+0.40 for WG-LASIK and WO-LASIK respectively.  Subgroup analysis based on changes in SE > 1, 2, 3, and 4 D showed similar higher ratios for WG-LASIK than WO-LASIK, however only achieved statistical significance in the > 3 D subgroup with a p-value of 0.02.  The mean of the ratio between changes in sim-K and SE for WG-LASIK was 1.05+1.05 and 0.8+0.07 (p-value: 0.11) for < and > 4 D SE change respectively.  Similarly, WO-LASIK was 0.95+0.51 and 0.78+0.10 (p-value: 0.04).

WG-LASIK and smaller refractive corrections consistently have larger changes in sim-K per unit of corrected SE over WO-LASIK and larger refractive corrections. These factors have important clinical implications in future intraocular lens selection for cataract surgery to prevent refractive surprises especially with the continued wider adoption of WG-LASIK.