title: Corneal wavefront-guided retreatments for significant night vision symptoms after myopic laser refractive surgery.
abstract: OBJECTIVE
  To evaluate the results of corneal wavefront (WF)-guided enhancements in patients with night vision symptoms and significantly high positive spherical aberration (SA) after myopic laser refractive surgery.
  
  
  METHODS
  Noncomparative, interventional case series.
  
  
  METHODS
  Twenty-eight eyes of 20 patients with significant night vision symptoms and positive corneal SA (Z(4)(0)) higher than 0.5 microm after myopic laser refractive surgery were included in the study at Vissum-Instituto Oftalmologico de Alicante, Spain. Enhancement surgery was planned to remove residual refractive error and corneal SA (Z(4)(0)) in all cases. All patients underwent corneal WF-guided excimer laser retreatments using the ESIRIS/SCHWIND excimer laser system (Schwind Eye Tech Solutions, Kleinostham, Germany). The main outcome measures were visual symptoms, change in corneal SA (Z(4)(0)), and corneal asphericity (Q-value).
  
  
  RESULTS
  Subjective reports of night vision symptoms were improved in all patients. Mean corneal SA (Z(4)(0)) decreased from 0.75 +/- 0.19 microm before surgery to 0.43 +/- 0.42 microm after surgery (P < .001). Mean asphericity in the 4.5-mm zone significantly decreased from 1.02 +/- 1.07 before surgery to 0.52 +/- 0.88 after surgery (P = .008), and the mean asphericity in 8 mm did not change significantly (P = .362). The mean spherical equivalent significantly shifted to hyperopia from -0.22 +/- 1.14 diopters (D) before surgery to 0.33 +/- 0.54 D after surgery (P = .025).
  
  
  CONCLUSIONS
  Cornea wavefront-guided retreatment was effective in improving subjective night vision symptoms, reducing corneal SA, and decreasing asphericity in eyes that underwent myopic laser refractive surgery.
authors.affiliation: Department of Refractive Surgery and Division of Ophthalmology, Instituto Oftalmológico de Alicante, Miguel Hernandez University, Alicante, Spain. jlalio@vissum.com
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.forename: David
authors.initials: D
authors.lastname: Piñero
authors.forename: Orkun
authors.initials: O
authors.lastname: Muftuoglu
mesh_terms: D000328:Adult; D000465:Algorithms; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery; D003315:Cornea / Q000503:physiopathology; D019781:Corneal Topography / Q000379:methods*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D009755:Night Blindness / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000379:methods*; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology