Refractive Outcomes, Contrast Sensitivity, HOAs, and Patient Satisfaction in Moderate Myopia: Wavefront-Optimized Versus Tissue-Saving PRK.
OBJECTIVE
To compare refractive outcomes, contrast sensitivity, higher-order aberrations (HOAs), and patient satisfaction after photorefractive keratectomy for correction of moderate myopia with two methods: tissue saving versus wavefront optimized.


METHODS
In this prospective, comparative study, 152 eyes (80 patients) with moderate myopia with and without astigmatism were randomly divided into two groups: the tissue-saving group (Technolas 217z Zyoptix laser; Bausch & Lomb, Rochester, NY) (76 eyes of 39 patients) or the wavefront-optimized group (WaveLight Allegretto Wave Eye-Q laser; Alcon Laboratories, Inc., Fort Worth, TX) (76 eyes of 41 patients). Preoperative and 3-month postoperative refractive outcomes, contrast sensitivity, HOAs, and patient satisfaction were compared between the two groups.


RESULTS
The mean spherical equivalent was -4.50 ± 1.02 diopters. No statistically significant differences were detected between the groups in terms of uncorrected and corrected distance visual acuity and spherical equivalent preoperatively and 3 months postoperatively. No statistically significant differences were seen in the amount of preoperative to postoperative contrast sensitivity changes between the two groups in photopic and mesopic conditions. HOAs and Q factor increased in both groups postoperatively (P = .001), with the tissue-saving method causing more increases in HOAs (P = .007) and Q factor (P = .039). Patient satisfaction was comparable between both groups.


CONCLUSIONS
Both platforms were effective in correcting moderate myopia with or without astigmatism. No difference in refractive outcome, contrast sensitivity changes, and patient satisfaction between the groups was observed. Postoperatively, the tissue-saving method caused a higher increase in HOAs and Q factor compared to the wavefront-optimized method, which could be due to larger optical zone sizes in the tissue-saving group.
Nader
N
Nassiri
Kourosh
K
Sheibani
Abbas
A
Azimi
Farinaz Mahmoodi
FM
Khosravi
Javad
J
Heravian
Abasali
A
Yekta
Hadi Ostadi
HO
Moghaddam
Saman
S
Nassiri
Mehdi
M
Yasseri
Nariman
N
Nassiri
D057128:Aberrometry; D000293:Adolescent; D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery; D015350:Contrast Sensitivity / Q000502:physiology*; D057108:Corneal Wavefront Aberration / Q000503:physiopathology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018903:Photorefractive Keratectomy / Q000379:methods*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology*; D055815:Young Adult