title: One-year outcomes from a prospective, randomized, eye-to-eye comparison of wavefront-guided and wavefront-optimized LASIK in myopes.
abstract: OBJECTIVE
  To compare wavefront (WF)-guided and WF-optimized LASIK in myopes.
  
  
  METHODS
  Prospective, randomized, eye-to-eye study.
  
  
  METHODS
  A total of 72 eyes of 36 participants with myopia with or without astigmatism.
  
  
  METHODS
  Participants were randomized to receive WF-guided or WF-optimized LASIK with the WaveLight Allegretto Eye-Q 400-Hz excimer laser platform (Alcon, Inc., Hüenberg, Switzerland). LASIK flaps were created using the 150-kHz IntraLase iFS (Abbott Medical Optics, Santa Ana, CA). Evaluations included measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), <5% and <25% contrast sensitivity, and WF aberrometry. Patients also completed a validated questionnaire detailing symptoms on a quantitative scale.
  
  
  METHODS
  Safety, efficacy, predictability, refractive error, UDVA, CDVA, contrast sensitivity, and higher-order aberrations (HOAs).
  
  
  RESULTS
  The frequency with which the WF-guided and WF-optimized groups achieved postoperative UDVA of ≥ 20/16 or ≥ 20/20 and the frequency with which the groups lost 1 or 2 or more lines or maintained their preoperative CDVA were not statistically different from each other (all P > 0.05). The frequency with which the WF-guided group attained a refractive error within ± 0.25 diopters of emmetropia was higher than in the WF-optimized group (67.6%, 95% confidence interval [CI], 50.4-84.8 vs. 41.2%, 95% CI, 23.2-59.2; P = 0.03). The WF-guided group's mean UDVA was better than the WF-optimized group's UDVA by approximately 1 Early Treatment Diabetic Retinopathy Study line (-0.17 ± 0.11 logarithm of the minimum angle of resolution [logMAR], slightly <20/12 Snellen vs. -0.13 ± 0.12, slightly >20/16; P = 0.05). There were no statistically significant differences in contrast sensitivity, astigmatism, coma, or higher-order root mean square error between the groups (all P > 0.05), but the WF-guided group had less trefoil compared with the WF-optimized group (0.14 ± 0.07 vs. 0.20 ± 0.09; P < 0.01). There were no statistically significant differences in subjective parameters between the groups (all P > 0.05).
  
  
  CONCLUSIONS
  Wavefront-guided and WF-optimized LASIK using the Alcon WaveLight Allegretto Eye-Q 400-Hz excimer laser platform provide similar results in myopic patients; however, the WF-guided approach may yield small gains in visual acuity, predictability, and HOAs.
authors.affiliation: Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Sáles
authors.affiliation: Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California. Electronic address: edward.manche@stanford.edu.
authors.forename: Edward E
authors.initials: EE
authors.lastname: Manche
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000601:surgery; D015350:Contrast Sensitivity / Q000502:physiology; D057108:Corneal Wavefront Aberration / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult