title: Wavefront-guided versus non-wavefront-guided photorefractive keratectomy for myopia: meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To compare the efficacy, predictability, safety, and induced higher-order aberrations (HOAs) between wavefront-guided and non-wavefront-guided photorefractive keratectomy (PRK).
  
  
  METHODS
  The Cochrane Central Register of Controlled Trials, PubMED, and EMBASE were searched for randomized controlled trials. Trials meeting the selection criteria were quality appraised, and data was extracted by 2 independent authors. Measures of association were pooled quantitatively using meta-analytical methods. Comparisons between wavefront-guided and non-wavefront-guided ablations were made as pooled odds ratios (ORs) or weighted mean differences. The pooled ORs and 95% confidence intervals (CIs) were computed for efficacy, safety, and predictability. The weighted mean differences and 95% CIs were used to compare induced HOAs.
  
  
  RESULTS
  The study covered five trials involving 298 eyes. After wavefront-guided PRK, the pooled OR of achieving an uncorrected distance visual acuity of 20/20 (efficacy) was 1.18 (95% CI, 0.53-2.60; p = 0.69), the pooled OR of achieving a result within ±0.50 diopter of the intended target (predictability) was 0.86 (95% CI, 0.40-1.84; p = 0.70). No study reported a loss of 2 or more lines of Snellen acuity (safety) with either modality. In eyes with wavefront-guided PRK, the postoperative trefoil aberrations (mean difference -0.02; 95% CI, -0.03 to -0.00; p = 0.03) were significantly lower. There were no significant differences between the two groups in the postoperative total HOAs (mean difference -0.04; 95% CI, -0.23 to 0.14; p = 0.63), spherical (mean difference 0.00; 95% CI, -0.08 to 0.09; p = 0.93), and coma (mean difference -0.06; 95% CI, -0.14 to 0.03; p = 0.20) aberrations.
  
  
  CONCLUSIONS
  According to the meta-analysis, wavefront-guided PRK offered no advantage in efficacy, predictability, or safety measures over non-wavefront-guided PRK, although it may have induced fewer trefoil aberrations.
authors: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
authors: Hidenaga
authors: H
authors: Kobashi
authors: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
authors: Kazutaka
authors: K
authors: Kamiya
authors: Department of Preventive Medicine, University of Kitasato School of Medicine, Kanagawa, Japan.
authors: Keika
authors: K
authors: Hoshi
authors: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
authors: Akihito
authors: A
authors: Igarashi
authors: Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan.
authors: Kimiya
authors: K
authors: Shimizu
mesh_terms: D002986:Clinical Trials as Topic; D057108:Corneal Wavefront Aberration; D016208:Databases, Factual; D006801:Humans; D009216:Myopia / Q000601:surgery*; D016017:Odds Ratio; D018903:Photorefractive Keratectomy; D016896:Treatment Outcome