Comparing conventional and wavefront-optimized LASIK for the treatment of hyperopia

• Published in: Journal of refractive surgery (1995) Vol. 26; no. 5; pp. 356 - 363
• Main Authors: Durrie, Daniel S, Smith, Ryan T, Waring, 4th, George O, Stahl, Jason E, Schwendeman, Frank J
• Format: Journal Article
• Language: English
• Published: United States SLACK INCORPORATED 01.05.2010
• Subjects: Ablation; Adult; Aged; Contrast Sensitivity - physiology; Cornea - physiopathology; Corneal Wavefront Aberration - physiopathology; Female; Humans; Hyperopia - physiopathology; Hyperopia - surgery; Keratomileusis, Laser In Situ - methods; Laboratories; Lasers; Lasers, Excimer - therapeutic use; Male; Middle Aged; Prospective Studies; Visual Acuity - physiology
• ISSN: 1081-597X; 1938-2391
• DOI: 10.3928/1081597X-20090617-07

To compare differences in visual outcomes and induced spherical aberration after conventional and wavefront-optimized LASIK for the treatment of hyperopia. In a prospective, randomized, single-center clinical trial, 51 consecutive eyes underwent LASIK for the treatment of hyperopia. Eyes were divided between groups treated with conventional LASIK with the Alcon LADAR4000 excimer laser (n=25) and wavefront-optimized LASIK with the WaveLight ALLEGRETTO excimer laser (n=26). Refractive and visual outcomes, induced spherical aberrations, and contrast sensitivity were analyzed. On postoperative day 1, 20% of eyes treated with a conventional profile had uncorrected visual acuity (UCVA) of 20/20 or better compared to 65% of eyes receiving wavefront-optimized treatment (P=.0011). By 6 months, UCVA was 20/20 or better in 72% and 84% of the conventional and wavefront-optimized treatment groups, respectively (P=.3254). At 6 months, the manifest refraction spherical equivalent was -0.21+/-0.47 diopters (D) and 0.16+/-0.27 D (P=.6469) whereas the cylinder was -0.41+/-0.47 D and -0.17+/-0.27 D (P=.0332) for the conventional and wavefront-optimized treatment groups, respectively. Induced spherical aberration was -0.54+/-0.32 microm and -0.42+/-0.21 microm for the conventional and wavefront-optimized treatment groups, respectively (P=.1195). The respective change in mesopic and photopic area under the log contrast sensitivity function was -0.05+/-0.29 and -0.05+/-0.23 for the conventional treatment group and 0.08+/-0.39 and 0.08+/-0.41 for the wavefront-optimized treatment group (P=.1970). Wavefront-optimized (ALLEGRETTO) and conventional (LADAR4000) ablation predictably and safely correct low to moderate hyperopia. Wavefront-optimized ablation showed superior results with regards to rapid visual recovery and residual cylinder. Although not statistically significant, a trend towards less induced negative spherical aberrations and improved mesopic and photopic contrast sensitivity was noted with wavefront-optimized treatment.