Vol. 2 No. 1 (2019): Current Issue
Research Article

Astigmatic Outcomes after Wavefront-Guided and Wavefront-Optimized Refractive Surgeries for Myopia with Low to Moderate Cylinder

Sia RK
Warfighter Refractive Eye Surgery Program and Research Center at Fort Belvoir, USA
Ryan DS
Warfighter Refractive Eye Surgery Program and Research Center at Fort Belvoir, USA
Stutsman RD
Ophthalmology Service, Walter Reed National Military Medical Center, USA
Pasternak JF
Ophthalmology Service, Walter Reed National Military Medical Center, USA
Eaddy JB
Warfighter Refractive Eye Surgery Program and Research Center at Fort Belvoir, USA
Logan LA
Warfighter Refractive Eye Surgery Program and Research Center at Fort Belvoir, USA
Rivers BA
Warfighter Refractive Eye Surgery Program and Research Center at Fort Belvoir, USA
Bower KS
The Wilmer Eye Institute, Johns Hopkins University, USA
Published November 25, 2019
Keywords
  • Wavefront-guided,
  • Wavefront-optimized,
  • PRK,
  • LASIK,
  • Astigmatism

Abstract

Purpose: To compare the efficacy and accuracy of wavefront-guided (WFG) and wavefront-optimized (WFO) PRK and LASIK for the treatment of myopia with low to moderate astigmatism.
Methods: In this prospective cohort study, 215 active duty military service members (430 eyes, mean spherical equivalent -3.61 ± 1.53 D) electing either PRK or LASIK were randomized to undergo WFG or WFO treatment. Up to 12 months, postoperative visual outcomes following surgeries were compared between 4 treatment groups: WFG PRK, WFG LASIK, WFO PRK, and WFO LASIK for myopia with 0.25 to 0.50 D astigmatism (≤ 0.50 D cyl subgroup) and ≥ 0.75 D astigmatism (≥ 0.75 D cyl subgroup). High and low contrast visual acuities were assessed and vector analysis was performed.
Results: At 12 months postoperatively, the surgically induced astigmatism, magnitude of error, correction and flattening indices were significantly different between treatment groups (P values ≤ 0.001) in the ≤ 0.50 D cyl subgroup. In ≥ the 0.75 D cyl subgroup, there were no significant differences in vector analysis parameters except for the magnitude of error and correction index (P values ≤ 0.010). The treatment groups were comparable in terms of postoperative uncorrected distance visual acuity, manifest spherical equivalent, and best-corrected low contrast visual acuity.
Conclusions: No treatment modality showed consistent superiority in correcting low to moderate astigmatism. Overall, both PRK and LASIK using either wavefront-guided or wavefront-optimized laser platforms were similarly effective and accurate in treating myopia with a low to moderate amount of astigmatism.