Arun Kumar Jain1, Chintan Malhotra2, Anand Pasari2, Pawan Kumar2, Majid Moshirfar2. 1. From the Advanced Eye Centre (Jain, Malhotra, Parasi, Kumar), Post Graduate Institute of Medical Education and Research, Chandigarh, India; the Department of Ophthalmology (Moshirfar), Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA. Electronic address: aronkjain@yahoo.com. 2. From the Advanced Eye Centre (Jain, Malhotra, Parasi, Kumar), Post Graduate Institute of Medical Education and Research, Chandigarh, India; the Department of Ophthalmology (Moshirfar), Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
Abstract
PURPOSE: To compare the outcomes of topography-guided and wavefront-optimized treatment in patients having laser in situ keratomileusis (LASIK) for myopia. SETTING: Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India. DESIGN: Prospective contralateral-eye case study. METHODS: Patients had topography-guided LASIK in 1 eye and wavefront-optimized LASIK in the contralateral eye using the Customized Refractive Surgery Master software and Mel 80 excimer laser. Refractive (residual manifest refraction spherical equivalent [MRSE], higher-order aberrations [HOAs]), and visual (uncorrected distance visual acuity [UDVA] and photopic and mesopic contrast sensitivity) outcomes were prospectively analyzed 6 months postoperatively. RESULTS: The study comprised 35 patients. The UDVA was 0.0 logMAR or better and the postoperative residual MRSE was ±0.50 diopter in 94.29% of eyes in the topography-guided group and 85.71% of eyes in the wavefront-optimized group (P = .09). More eyes in the topography-guided group than in the wavefront-optimized group had a UDVA of -0.1 logMAR or better (P = .04). Topography-guided LASIK was associated with less deterioration of mesopic contrast sensitivity at higher spatial frequencies (12 cycles per degree [cpd] and 18 cpd) and lower amounts of induced coma (P = .04) and spherical aberration (P = .04). Less stromal tissue was ablated in the topography-guided group (mean 61.57 μm ± 16.23 [SD]) than in the wavefront-optimized group (mean 79.71 ± 14.81 μm) (P < .001). CONCLUSION: Although topography-guided LASIK and wavefront-optimized LASIK gave excellent results, topography-guided LASIK was associated with better contrast sensitivity, lower induction of HOAs, and a smaller amount of tissue ablation. FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.
PURPOSE: To compare the outcomes of topography-guided and wavefront-optimized treatment in patients having laser in situ keratomileusis (LASIK) for myopia. SETTING: Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India. DESIGN: Prospective contralateral-eye case study. METHODS:Patients had topography-guided LASIK in 1 eye and wavefront-optimized LASIK in the contralateral eye using the Customized Refractive Surgery Master software and Mel 80 excimer laser. Refractive (residual manifest refraction spherical equivalent [MRSE], higher-order aberrations [HOAs]), and visual (uncorrected distance visual acuity [UDVA] and photopic and mesopic contrast sensitivity) outcomes were prospectively analyzed 6 months postoperatively. RESULTS: The study comprised 35 patients. The UDVA was 0.0 logMAR or better and the postoperative residual MRSE was ±0.50 diopter in 94.29% of eyes in the topography-guided group and 85.71% of eyes in the wavefront-optimized group (P = .09). More eyes in the topography-guided group than in the wavefront-optimized group had a UDVA of -0.1 logMAR or better (P = .04). Topography-guided LASIK was associated with less deterioration of mesopic contrast sensitivity at higher spatial frequencies (12 cycles per degree [cpd] and 18 cpd) and lower amounts of induced coma (P = .04) and spherical aberration (P = .04). Less stromal tissue was ablated in the topography-guided group (mean 61.57 μm ± 16.23 [SD]) than in the wavefront-optimized group (mean 79.71 ± 14.81 μm) (P < .001). CONCLUSION: Although topography-guided LASIK and wavefront-optimized LASIK gave excellent results, topography-guided LASIK was associated with better contrast sensitivity, lower induction of HOAs, and a smaller amount of tissue ablation. FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.