Conservation of corneal tissue with wavefront-guided laser in situ keratomileusis.
OBJECTIVE
To determine whether corneal tissue can be conserved with wavefront-guided ablation compared to conventional surgery with a larger ablation zone for attempted prevention of glare and halo.


METHODS
Department of Ophthalmology, Ilsan Paik Hospital, Inje University, Korea.


METHODS
This prospective study was composed of 2 parts: First, 40 eyes of 20 patients were studied to determine whether a larger optical ablation could be beneficial in prevention of glare after conventional laser in situ keratomileusis (LASIK) surgery. One eye in each patient was treated with a 6.00 mm optical zone, and the other with a 6.25 mm optical zone. Second, 20 eyes of 10 patients with a higher-order root mean square (RMS) value of 0.3 or greater were evaluated to learn whether a wavefront-guided ablation could be as effective as a larger conventional optical ablation. One eye in each patient was treated by conventional LASIK surgery with a 6.25 mm optical zone, and the other eye was treated by wavefront-guided LASIK surgery with a 6.00 mm optical zone. All patients were analyzed with a WASCA analyzer (Carl Zeiss Meditec) preoperatively, and 1 month and 3 months after surgery.


RESULTS
Higher-order aberrations including coma, spherical aberration, and higher-order RMS were statistically significantly increased after conventional surgery with both a 6.00 mm and 6.25 mm optical zone. High-order aberrations including comaer- and spherical aberration after conventional surgery with 6.25 mm zone were statistically significantly increased. However, coma and higher-order RMS did not show a statistically significant increase between pre-LASIK and post-LASIK in wavefront-ablated eyes with a 6.00 mm optical zone.


CONCLUSIONS
Wavefront ablation showed less increase of coma and higher-order RMS regardless of a smaller optical zone. This finding might provide a clinical clue for an advantage of wavefront-guided ablation from the standpoint of corneal tissue conservation.
Lee
Do-Hyung
DH
Department of Ophthalmology, Ilsan Paik Hospital, Inje University, Koyang, Korea. dhlee@ilsanpaik.ac.kr
Oh
Jae Ryong
JR
Reinstein
Dan Z
DZ
D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D057108:Corneal Wavefront Aberration / Q000209:etiology; D005260:Female; D019466:Glare; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D013524:Surgical Flaps; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult