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Comparison of higher-order aberrations after wavefront-guided laser in situ keratomileusis and laser-assisted subepithelial keratectomy.

Chung SH, Lee IS, Lee YG, Lee HK, Kim EK, Yoon G, Seo KY

Department of Ophthalmology, Yonsei Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.

PURPOSE: To compare the higher-order aberrations (HOAs) in 70 eyes (38 patients) that had wavefront-guided laser in situ keratomileusis (LASIK) with those in 70 eyes (40 patients) that had wavefront-guided laser-assisted subepithelial keratectomy (LASEK) for the treatment of myopia. SETTING: Department of Ophthalmology, Yonsei University College of Medicine, Myongdong Bal-geun sesang Eye Clinic, and Seran Eye Center, Seoul, Korea. METHODS: In a prospective study, 140 consecutive eyes of 78 patients were treated with wavefront-guided LASIK or LASEK according to the patient's choice after each procedure had been thoroughly explained. The patients were followed for 6 months. Best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), manifest refraction, and wavefront aberrations were measured at baseline and 1, 3, and 6 months after surgery. RESULTS: There were no significant differences in postoperative BCVA, UCVA, and manifest refraction between groups. The mean root-mean-square wavefront error of HOAs for a scotopic pupil in the wavefront-guided LASIK group was significantly smaller than that in the wavefront-guided LASEK group at 1 month. Analyzing individual Zernike coefficients, the spherical aberration and second coma were significantly smaller in the wavefront-guided LASIK group than in the wavefront-guided LASEK group at 1 month. This difference in HOAs between groups disappeared at 3 and 6 months. CONCLUSIONS: The HOAs in the scotopic condition were not different between the wavefront-guided LASIK and LASEK groups beginning 3 months after surgery. However, the HOAs in the LASIK and LASEK groups had a different time course, especially in the case of spherical aberration. This finding suggests that postoperative changes in aberration contribute to the final outcome of wavefront-guided ablation.

Published 12 June 2006 in J Cataract Refract Surg, 32(5): 779-84.
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