Visual outcomes after wavefront-guided photorefractive keratectomy and wavefront-guided laser in situ keratomileusis: Prospective comparison.
OBJECTIVE
To compare visual outcomes between wavefront-guided photorefractive keratectomy (PRK) and wavefront-guided laser in situ keratomileusis (LASIK).


METHODS
Academic center, Salt Lake City, Utah, USA.


METHODS
In this randomized prospective study, myopic eyes were treated with wavefront-guided PRK and or wavefront-guided LASIK using a Visx Star S4 CustomVue platform with iris registration. Primary outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities and manifest refraction. Secondary outcome measures were higher-order aberrations (HOAs) and contrast sensitivity.


RESULTS
The PRK group comprised 101 eyes and the LASIK group, 102 eyes. At 6 months, the mean UDVA was -0.03 logMAR +/- 0.10 [SD] (20/19) and 0.07 +/- 0.09 logMAR (20/24), respectively (P = .544). In both groups, 75% eyes achieved a UDVA of 20/20 or better (P = .923); 77% of eyes in the PRK group and 88% in the LASIK group were within +/-0.50 diopter of emmetropia (P = .760). There was no statistically significant difference between groups in contrast sensitivity at 3, 6, 12, or 18 cycles per degree. The mean postoperative HOA root mean square was 0.45 +/- 0.13 mum in the PRK group and 0.59 +/- 0.22 mum in the LASIK group (P = .012), representing an increase factor of 1.22 and 1.74, respectively.


CONCLUSIONS
Wavefront-guided PRK and wavefront-guided LASIK had similar efficacy, predictability, safety, and contrast sensitivity; however, wavefront-guided PRK induced statistically fewer HOAs than wavefront-guided LASIK at 6 months.


BACKGROUND
No author has a financial or proprietary interest in any material or method mentioned.
Moshirfar
Majid
M
Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, Salt Lake City, Utah 84132, USA. majid.moshirfar@hsc.utah.edu
Schliesser
Joshua A
JA
Chang
Joann C
JC
Oberg
Thomas J
TJ
Mifflin
Mark D
MD
Townley
Richard
R
Livingston
Myrna K
MK
Kurz
Christopher J
CJ
D057128:Aberrometry; D000328:Adult; D015350:Contrast Sensitivity / Q000502:physiology; D003319:Corneal Stroma / Q000601:surgery; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000503:physiopathology; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D018903:Photorefractive Keratectomy; D011446:Prospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult