title: Visual acuity and higher-order aberrations with wavefront-guided and wavefront-optimized laser in situ keratomileusis.
abstract: OBJECTIVE
  To compare visual acuity and higher-order aberrations (HOAs) after wavefront-guided and wavefront-optimized laser in situ keratomileusis (LASIK).
  
  
  METHODS
  This retrospective study comprised refraction-matched myopic eyes that had wavefront-guided (Visx Star S4 laser) or wavefront-optimized (WaveLight Allegretto Wave laser) LASIK targeted for emmetropia. Preoperative and postoperative manifest refraction spherical equivalent (MRSE), uncorrected (UDVA) and corrected (CDVA) distance visual acuities, and preoperative and postoperative HOAs were compared.
  
  
  RESULTS
  Preoperatively, there were no significant differences between the wavefront-guided and wavefront-optimized groups in age, sex, corneal thickness, MRSE, or HOAs (all P>.05). The mean MRSE was -2.88 diopters (D) +/- 2.6 (SD) and -2.96 +/- 2.6 D, respectively, preoperatively and -0.01 +/- 0.25 D and -0.02 +/- 0.33 D, respectively, postoperatively; 96% of all eyes were within +/-0.50 D of emmetropia postoperatively. There were no differences in UDVA, CDVA, MRSE, or HOAs between groups (all P>.05). The UDVA was 20/20 or better in 85% of eyes in the wavefront-guided group and 86% of eyes in the wavefront-optimized group. All eyes had 20/25 or better CDVA postoperatively; no eye lost 2 lines of CDVA. Fourteen eyes were converted from wavefront-guided to wavefront-optimized treatment because of poor limbal ring alignment (8 eyes), a wave scan not consistent with the manifest refraction (5 eyes), and no iris registration (1 eye).
  
  
  CONCLUSIONS
  Wavefront-guided LASIK and wavefront-optimized LASIK produced equivalent visual outcomes and no differences in HOAs. Wavefront-guided treatment could not be performed in many eyes because of difficulties during wavefront measurement.
authors.affiliation: Emory Vision, Atlanta, Georgia, USA.
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Perez-Straziota
authors.forename: J Bradley
authors.initials: JB
authors.lastname: Randleman
authors.forename: R Doyle
authors.initials: RD
authors.lastname: Stulting
mesh_terms: D000293:Adolescent; D000328:Adult; D057108:Corneal Wavefront Aberration / Q000517:prevention & control; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult