Comparison of Early Outcomes of Topography-Guided Photorefractive Keratectomy With 2 Refractive Lasers
Purpose
To evaluate early results of topography-guided photorefractive keratectomy (TG-PRK) with simultaneous collagen cross-linking (CXL) between Wavelight Allegretto (WA) and Schwind Amaris (SA) refractive lasers for keratoconus (KC)
Methods
Two-hundred seventy-four eyes underwent TG-PRK CXL using WA while 37 using SA. Trans epithelial PRK was performed with a custom Topographical Neutralization Technique (TNT). Pre and post-operative assessment of symptoms, uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), manifest refraction (MR) predictability, and safety were analyzed at 1, 3, and 6 months
Results
One-hundred eighty cases of WA and 29 cases of SA have sufficient data at 6 months follow-up for analysis. 101/180 (56%) of WA and 17/29 (59%) of SA had ≥20/40 UCVA. 170 (94%) of WA and 27 (93%) of SA had ≥20/40 BSCVA. 94 (52%) of WA and 16 (55%) of SA had BSCVA improved. 40 (22%) of WA and 8 (28%) of SA had BSCVA improved ≥2 lines. Mean astigmatism reduction are 1.82±1.52D for WA and 1.85±1.65D for SA. Mean spherical equivalent changes are -2.88±2.28D to -1.52±1.28D for WA and -2.74±2.21D to -1.24±2.18D for SA
Conclusion
Comparison of SA TG PRK and WA TG PRK with CXL showed no significant difference in outcomes in early follow-up, half obtained ≥20/40 UCVA and improved BSCVA. SA has advantage of excellent tracking, cyclotorsion control and multiple customizable options while WA has established nomograms with studies showing efficacy and safety.