Effect of Wavefront-Guided and Wavefront-Optimized LASIK on Optical Quality and Military Task Performance in U.S. Soldiers

Friday, April 17, 2015
KIOSKS (San Diego Convention Center)
Richard D. Stutzman, MD
Rose Kristine C. Sia, MD
Bruce A. Rivers, MD
Tana Maurer
Christopher Howell, PhD
Kraig S. Bower, MD

Purpose
To determine the effect of WFG and WFO LASIK on higher order aberrations (HOA) and the ability to detect and discriminate human and combat vehicle targets presented in infrared imagery.

Methods
Twenty-six soldiers were randomized to undergo either WFG (n=12; CustomVue STAR S4 IR) or WFO femtosecond LASIK (n=14; Wavelight Allegretto Wave EyeQ). Wavefront analysis was performed on natural pupils using a Shack-Hartmann aberrometer at preop and 6 months (M) postop. The absolute root mean square for coma, trefoil, spherical aberration and total HOA were calculated at 6-mm pupil diameter. In computer-based tasks at preop, 6 weeks and 6M postop, participants searched for human targets in high clutter infrared scenes and identified vehicle targets. Probability of detection (Pd) and probability of identification (PID) were analyzed and compared; P<0.05 was considered significant.

Results
Mean age in study was 30.7±5.4 years and myopia was -3.73±1.42 diopters. There were no significant differences between WFG and WFO LASIK in the amount of coma, trefoil, spherical aberration and total HOA over time (P>0.05). For the human search experiment, 6 of 7 WFG participants and 6 of 9 WFO participants scored equivalent to or better than preoperative Pd (P=0.58). For combat vehicle identification experiment, 7 of 7 WFG participants and 9 of 9 WFO participants scored equivalent to or better than preoperative PID (P=0.99).

Conclusion
WFG and WFO LASIK had a similar effect on HOAs after surgery. Changes in military task performance for human detection and vehicle identification were maintained or improved following either WFG or WFO LASIK.