title: Clinical outcomes of laser in situ keratomileusis using combined topography and refractive wavefront treatments for myopic astigmatism.
abstract: OBJECTIVE
  To evaluate outcomes of laser in situ keratomileusis (LASIK) guided by wavefront alone versus wavefront plus topographic data.
  
  
  METHODS
  NewVision Clinics, Cheltenham, Australia.
  
  
  METHODS
  Twenty-one eyes (14 patients) were distributed into 2 groups in a prospective double-masked study. One group was treated by wavefront parameters alone (WF, n = 11), and the other, by wavefront combined with topography values (WF&VP, n = 10) using vector planning. All treatments were performed using Visx Star S4 CustomVue software. In the WF&VP group, the treatment profile was calculated using simulated keratometry readings from the Humphrey Atlas topography and 2nd-order Zernike coefficients defocus 4 and astigmatism 3 and 5 from the WaveScan wavefront display of the entire eye.
  
  
  RESULTS
  Mean corneal astigmatism preoperatively was 1.07 diopters (D) +/- 0.54 (SD) in the WF group and 1.50 +/- 0.87 D in the WF&VP group. At 6 months, it was 0.67 +/- 0.57 D (39% reduction) and 0.83 +/- 0.55 D (44% reduction), respectively. The WF&VP group had a greater reduction in horizontal coma. The mean gain in low-contrast visual acuity under mesopic conditions was 0.06 in the WF group and 0.11 in the WF&VP group and the mean gain in high-contrast visual acuity, 0.02 and 0.05, respectively. Two patients reported a change in the preferred eye postoperatively to the eye treated using vector planning. No result demonstrated statistical significance.
  
  
  CONCLUSIONS
  The WF&VP group had greater reduction in corneal astigmatism and better visual outcomes under mesopic conditions than the WF group and equivalent higher-order aberrations.
authors.affiliation: NewVision Clinics, Cheltenham, VIC, Australia. nalpins@unimelb.edu.au <nalpins@unimelb.edu.au>
authors.forename: Noel
authors.initials: N
authors.lastname: Alpins
authors.forename: George
authors.initials: G
authors.lastname: Stamatelatos
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology