Comparing conventional and wavefront-optimized LASIK for the treatment of hyperopia.
OBJECTIVE
To compare differences in visual outcomes and induced spherical aberration after conventional and wavefront-optimized LASIK for the treatment of hyperopia.


METHODS
In a prospective, randomized, single-center clinical trial, 51 consecutive eyes underwent LASIK for the treatment of hyperopia. Eyes were divided between groups treated with conventional LASIK with the Alcon LADAR4000 excimer laser (n=25) and wavefront-optimized LASIK with the WaveLight ALLEGRETTO excimer laser (n=26). Refractive and visual outcomes, induced spherical aberrations, and contrast sensitivity were analyzed.


RESULTS
On postoperative day 1, 20% of eyes treated with a conventional profile had uncorrected visual acuity (UCVA) of 20/20 or better compared to 65% of eyes receiving wavefront-optimized treatment (P=.0011). By 6 months, UCVA was 20/20 or better in 72% and 84% of the conventional and wavefront-optimized treatment groups, respectively (P=.3254). At 6 months, the manifest refraction spherical equivalent was -0.21+/-0.47 diopters (D) and 0.16+/-0.27 D (P=.6469) whereas the cylinder was -0.41+/-0.47 D and -0.17+/-0.27 D (P=.0332) for the conventional and wavefront-optimized treatment groups, respectively. Induced spherical aberration was -0.54+/-0.32 microm and -0.42+/-0.21 microm for the conventional and wavefront-optimized treatment groups, respectively (P=.1195). The respective change in mesopic and photopic area under the log contrast sensitivity function was -0.05+/-0.29 and -0.05+/-0.23 for the conventional treatment group and 0.08+/-0.39 and 0.08+/-0.41 for the wavefront-optimized treatment group (P=.1970).


CONCLUSIONS
Wavefront-optimized (ALLEGRETTO) and conventional (LADAR4000) ablation predictably and safely correct low to moderate hyperopia. Wavefront-optimized ablation showed superior results with regards to rapid visual recovery and residual cylinder. Although not statistically significant, a trend towards less induced negative spherical aberrations and improved mesopic and photopic contrast sensitivity was noted with wavefront-optimized treatment.
Durrie
Daniel S
DS
Durrie Vision, 5520 College Boulevard, Overland Park, KS 66211, USA. ddurrie@durrievision.com
Smith
Ryan T
RT
Waring
George O
GO
Stahl
Jason E
JE
Schwendeman
Frank J
FJ
D000328:Adult; D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology; D003315:Cornea / Q000503:physiopathology; D057108:Corneal Wavefront Aberration / Q000503:physiopathology; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014792:Visual Acuity / Q000502:physiology*