Topography-Guided vs Wavefront-Optimized Surface Ablation for Myopia Using the WaveLight Platform: A Contralateral Eye Study.
OBJECTIVE
to compare treatments with wavefront-optimized and topography-guided ablations.


METHODS
this prospective, randomized, contralateral study comprised 40 eyes (20 patients) with low to moderate myopia with or without astigmatism that underwent topography-guided photorefractive keratectomy (PRK) (ALLEGRO Topolyzer, Alcon Laboratories Inc) in one eye and wavefront-optimized PRK (ALLEGRETTO WAVE software version 2.020 default treatment, Alcon Laboratories Inc) in the fellow eye. Visual acuity, refractive error, contrast sensitivity, and Orbscan (Bausch & Lomb) 3- and 5-mm corneal irregularities were measured preoperatively and 3 and 6 months postoperatively. The results were compared between the two eyes.


RESULTS
in both groups, preoperative corrected distance visual acuity (CDVA) (0.03±0.09 logMAR for topography-guided and 0.01 ± 0.06 logMAR for wavefront-optimized [P=.1]), 3-month postoperative uncorrected distance visual acuity (UDVA) (-0.0 1± 0.03 logMAR for topography-guided and -0.01 ± 0.03 logMAR for wavefront-optimized [P=.4]), and 6-month postoperative UDVA (0.01 ± 0.03 logMAR for topography-guided and 0.0 ± 0.01 logMAR for wavefront-optimized [P=.3]) were the same. All wavefront-optimized and 18 (90%) topography-guided eyes had UDVA of 20/20 or better. No significant differences were noted between groups in pre- and postoperative spherical and cylindrical refractive errors or corneal irregularity and contrast sensitivity measurements. Six months postoperatively, contrast sensitivity values at 3, 6, 12, and 18 cycles/degree were 5.7 ± 0.7, 6.0 ± 1.5, 6.1 ± 1.3, and 5.5 ± 1.5, respectively, in the topography-guided group, and 6.2 ± 0.6, 6.4 ±1.2, 6.4 ± 1.1, and 5.8 ± 1.3, respectively, in the wavefront-optimized group (P=.3, P=.5, P=.4, and P=.6, respectively).


CONCLUSIONS
using the WaveLight excimer laser platform for PRK, CDVA and contrast sensitivity outcomes were statistically similar between the wavefront-optimized and topography-guided ablations in eyes with low to moderate myopia with and without astigmatism.
Falavarjani
Khalil Ghasemi
KG
Eye Research Center, Iran University of Medical Science, Iran. drghasemi@yahoo.com
Hashemi
Masih
M
Modarres
Mehdi
M
Sanjari
Mostafa Soltan
MS
Darvish
Niloufar
N
Gordiz
Arzhang
A
D057128:Aberrometry / Q000379:methods; D000293:Adolescent; D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery; D015350:Contrast Sensitivity / Q000502:physiology; D019781:Corneal Topography / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult