Higher order aberrations and relative risk of symptoms after LASIK.
OBJECTIVE
To understand what level of higher order aberrations increases the relative risk of visual symptoms in patients after myopic LASIK.


METHODS
This study was a retrospective comparative analysis of 103 eyes of 62 patients divided in two groups, matched for age, gender, pupil size, and spherical equivalent refraction. The symptomatic group comprised 36 eyes of 24 patients after conventional LASIK with different laser systems evaluated in our referral clinic and the asymptomatic control group consisted of 67 eyes of 38 patients following LADARVision CustomCornea wavefront LASIK. Comparative analysis was performed for uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contrast sensitivity, refractive cylinder, and higher order aberrations. Wavefront analysis was performed with the LADARWave aberrometer at 6.5-mm analysis for all eyes.


RESULTS
Blurring of vision was the most common symptom (41.6%) followed by double image (19.4%), halo (16.7%), and fluctuation in vision (13.9%) in symptomatic patients. A statistically significant difference was noted in UCVA (P = .001), BSCVA (P = .001), contrast sensitivity (P < .001), and manifest cylinder (P = .001) in the two groups. The percentage difference between the symptomatic and control group mean root-mean-square (RMS) values ranged from 157% to 206% or 1.57 to 2.06 times greater.


CONCLUSIONS
Patients with visual symptoms after LASIK have significantly lower visual acuity and contrast sensitivity and higher mean RMS values for higher order aberrations than patients without symptoms. Root-mean-square values of greater than two times the normal after-LASIK population for any given laser platform may increase the relative risk of symptoms.
Sharma
Munish
M
Boxer Wachler Vision Institute, 465 N Roxbury Dr, Ste 902, Beverly Hills, CA 90210, USA.
Wachler
Brian S Boxer
BS
Chan
Colin C K
CC
D000328:Adult; D015350:Contrast Sensitivity / Q000502:physiology; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D008297:Male; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology