title: Wavefront-Guided Versus Wavefront-Optimized Photorefractive Keratectomy: Visual and Military Task Performance.
abstract: To compare visual performance, marksmanship performance, and threshold target identification following wavefront-guided (WFG) versus wavefront-optimized (WFO) photorefractive keratectomy (PRK).
  
  
  
  In this prospective, randomized clinical trial, active duty U.S. military Soldiers, age 21 or over, electing to undergo PRK were randomized to undergo WFG (n = 27) or WFO (n = 27) PRK for myopia or myopic astigmatism. Binocular visual performance was assessed preoperatively and 1, 3, and 6 months postoperatively: Super Vision Test high contrast, Super Vision Test contrast sensitivity (CS), and 25% contrast acuity with night vision goggle filter. CS function was generated testing at five spatial frequencies. Marksmanship performance in low light conditions was evaluated in a firing tunnel. Target detection and identification performance was tested for probability of identification of varying target sets and probability of detection of humans in cluttered environments.
  
  
  
  Visual performance, CS function, marksmanship, and threshold target identification demonstrated no statistically significant differences over time between the two treatments. Exploratory regression analysis of firing range tasks at 6 months showed no significant differences or correlations between procedures. Regression analysis of vehicle and handheld probability of identification showed a significant association with pretreatment performance.
  
  
  
  Both WFG and WFO PRK results translate to excellent and comparable visual and military performance.
authors.affiliation: Warfighter Refractive Eye Surgery Program and Research Center, Fort Belvoir Community Hospital, 9300 DeWitt Loop, Fort Belvoir, VA 22060.
authors.forename: Denise S
authors.initials: DS
authors.lastname: Ryan
authors.affiliation: Warfighter Refractive Eye Surgery Program and Research Center, Fort Belvoir Community Hospital, 9300 DeWitt Loop, Fort Belvoir, VA 22060.
authors.forename: Rose K
authors.initials: RK
authors.lastname: Sia
authors.affiliation: Ophthalmology Service, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Stutzman
authors.affiliation: Ophthalmology Service, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Pasternak
authors.affiliation: Biostatistics Section, Department of Research Programs, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889.
authors.forename: Robin S
authors.initials: RS
authors.lastname: Howard
authors.affiliation: Night Vision and Electronic Sensors Directorate, Fort Belvoir, VA 22060.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Howell
authors.affiliation: Night Vision and Electronic Sensors Directorate, Fort Belvoir, VA 22060.
authors.forename: Tana
authors.initials: T
authors.lastname: Maurer
authors.affiliation: Ophthalmology Service, Madigan Army Medical Center, 9040 Jackson Avenue, Tacoma, WA 98431.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Torres
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University, 10753 Falls Road, Lutherville, MD 21093.
authors.forename: Kraig S
authors.initials: KS
authors.lastname: Bower
mesh_terms: D000328:Adult; D005260:Female; D005389:Firearms / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D055254:Night Vision; D018903:Photorefractive Keratectomy / Q000379:methods*; D011446:Prospective Studies; D013647:Task Performance and Analysis; D014792:Visual Acuity