Higher-Order Aberrations After Myopic Wavefront-Guided and Wavefront-Optimized Refractive Surgery

Friday, April 17, 2015
KIOSKS (San Diego Convention Center)
Rose Kristine C. Sia, MD
Denise S. Ryan, MS
Richard D. Stutzman, MD
Lorie A. Logan, OD
Bruce A. Rivers, MD
Kraig S. Bower, MD

Purpose
To evaluate changes in higher order aberrations (HOA) following wavefront guided (WFG) and wavefront optimized (WFO) refractive surgery.

Methods
215 myopic patients (mean age 30.1±6.8 years) undergoing either femtosecond LASIK or PRK were randomized to receive either WFG (CustomVue STAR S4 IR) or WFO treatment (Wavelight Allegretto Wave EyeQ). Wavefront aberrometry was performed on natural pupils at  preop and 6 months postop using a Shack-Hartmann aberrometer (Complete Ophthalmic Analysis System). The absolute root mean square wavefront error for coma, trefoil, spherical aberration and total HOA were determined at 6-mm pupil. A paired sample t-test used to compare HOA within each group. A repeated measures analysis of variance was performed to compare between groups over time; P<0.05 was considered significant.

Results
191 eyes (mean manifest spherical equivalent -3.50±1.47 diopters) were included in the analysis. In a within group comparison, at 6 months postop, there was a significant increase in the amount of coma, spherical aberration and total HOA was observed in WFG LASIK (P<0.01) whereas a significant increase in trefoil, spherical aberration and total HOA was seen in WFO LASIK (P<0.01). There was a significant increase in the amount of spherical aberration and total HOA (P<0.01) in both the WFG PRK and WFO PRK group. Amongst all four treatment groups, there was no significant difference in terms of change in coma, trefoil, spherical aberration and total HOA over time (P>0.05).

Conclusion
HOAs change significantly following laser refractive surgery. Treatment using either surgical technique performed on either laser platform appears to have similar effect on postoperative wavefront errors.