Quality of Vision After Wavefront-Guided and Wavefront-Optimized LASIK

Monday, April 20, 2015: 3:26 PM
Room 1A (San Diego Convention Center)
Edward E. Manche, MD
Jennifer Kung, MD

To prospectively measure quality of vision after wavefront-guided and wavefront-optimized LASIK surgery in myopic patients.

Fifty-five patients (110 eyes) were enrolled in this prospective, randomized, fellow eye controlled study. One eye was randomized to undergo WFG LASIK treatment by the AMO Visx CustomVue S4 IR excimer laser system (Abbott Medical Optics, Inc.) and the fellow eye received WFO LASIK treatment by the Alcon Allegretto Wave Eye-Q 400 Hz excimer laser system (Alcon Laboratories, Inc.). Patients answered a validated Rasch-scaled questionnaires measuring quality of vision preoperatively and at 1, 3, 6, and 12 months after surgery.

Patients in both groups reported better vision compared to baseline from 3 months onward (P < 0.003).  There were no statistically significant differences in symptoms between the two groups at twelve months with the exception of self-reported “excellent vision” with more WFG treated eyes rated as having excellent vision compared to WFO treated eyes (P = 0.039).  A subset analysis of patients with a preoperative higher order RMS < 0.3 microns in both eyes revealed multiple significant differences in symptoms with WFO eyes reporting more problems with nighttime clarity (WFG vs. WFO; 1.38 vs. 3.00; P = 0.009); daytime clarity (WFG vs. WFO 0.69 vs. 2.07; P = 0.015) and fluctuating vision (WFG vs. WFO; 0.92 vs. 1.69; P = 0.046).

One year after surgery, patient self-reported visual symptoms were not significantly different in eyes receiving WFG or WFO LASIK.  However, patients with preoperative higher order RMS values less than 0.3 microns in both eyes experienced a small but statistically significant advantage in self-reported quality of vision with WFG LASIK compared to WFO LASIK.