title: Advanced corneal surface ablation efficacy in myopia: changes in higher order aberrations.
abstract: OBJECTIVE
  To evaluate the change of ocular and corneal higher order aberrations (HOAs) after wavefront-guided advanced surface ablation (WF-ASA) for myopia using 4 different epithelial management techniques (AA-PRK, LASEK, Epi-PRK, and Epi-LASIK).
  
  
  METHODS
  Retrospective single centre excimer database analysis.
  
  
  METHODS
  Two hundred and forty eyes equally divided between the 4 WF-ASA techniques, matched for mean and range of required spherical correction.
  
  
  METHODS
  Ocular wavefront aberrations were measured using the wavescan aberrometer and corneal aberrations were obtained from corneal topography elevation maps and calculated by ray-tracing. All data were collected preoperatively and 3 months following treatment. The aberrations were described as Zernike polynomials, and analysis focused on total HOAs and spherical aberration (SA).
  
  
  RESULTS
  Three months postoperatively, there was a statistically significant surgically induced increase in total HOAs and SA both for ocular and corneal analysis (p < 0.001). There was no statistically significant difference in the induced ocular SA and HOAs between the groups, but the differences in induced corneal SA and HOAs were significant (p < 0.010). Ocular changes in SA were weakly correlated to preoperative SA (20.30, p < 0.001) but strongly correlated to applied spherical correction (20.68, p < 0.001). Surgically induced corneal SA was weakly correlated to preoperative corneal SA (20.34, p < 0.001) and applied spherical correction (20.46, p < 0.001).
  
  
  CONCLUSIONS
  Three months postoperatively, all procedures resulted in an increase in ocular and cornealHOAs and SA. Induced aberrations were most strongly correlated to the applied spherical power correction. Modifying the existing ablation pattern to compensate for induced HOAs might improve the outcome.
authors.affiliation: Department of Surgery, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE. uaeye27@hotmail.com
authors.forename: Tahra
authors.initials: T
authors.lastname: AlMahmoud
authors.forename: Rejean
authors.initials: R
authors.lastname: Munger
authors.forename: W Bruce
authors.initials: WB
authors.lastname: Jackson
mesh_terms: D057128:Aberrometry; D003319:Corneal Stroma / Q000601:surgery*; D057108:Corneal Wavefront Aberration / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted / Q000379:methods*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D009216:Myopia / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity