Comparison of outcomes after topography-modified refraction versus wavefront-optimized versus manifest topography-guided LASIK

• Published in: BMC ophthalmology Vol. 20; no. 1; p. 192
• Main Authors: Kim, Jaeryung, Choi, Sung-Ho, Lim, Dong Hui, Yoon, Gil-Joong, Chung, Tae-Young
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.05.2020; BioMed Central; BMC
• Subjects: Acuity; Adult; Astigmatic overcorrection; Comparative analysis; Contact lenses; Cornea; Corneal Topography - methods; Eye surgery; Female; Humans; Keratomileusis, Laser In Situ - methods; Lasers; LASIK; Male; Medical research; Middle Aged; Myopia; Myopia - diagnosis; Myopia - physiopathology; Myopia - surgery; Ophthalmology; Refraction; Refraction, Ocular - physiology; Retrospective Studies; Surgery, Computer-Assisted - methods; Surgical outcomes; Topography; Topography-guided LASIK; Topography-modified refraction LASIK; Treatment Outcome; Tropicamide; Variance analysis; Visual Acuity; Wavefront-optimized LASIK; United States > US; Wavefront-optimized LASIK; Topography-modified refraction LASIK; Topography-guided LASIK; LASIK; Astigmatic overcorrection
• ISSN: 1471-2415; 1471-2415
• DOI: 10.1186/s12886-020-01459-0

To compare the outcomes of myopia and myopic astigmatism corrected with topography-modified refraction laser in situ keratomileusis (TMR-LASIK), wavefront-optimized (WFO) LASIK, and topography-guided (TG) LASIK with a correction target based on the manifest refraction (manifest TG-LASIK). This observational, retrospective cohort study included patients who underwent LASIK using the WaveLight® EX500 excimer laser to correct myopia and myopic astigmatism between August 2016 and July 2017. Patients who underwent TMR-LASIK (85 patients), WFO-LASIK (70 patients), or manifest TG-LASIK (40 patients) were enrolled, and only one eye from each patient was analyzed. All participants underwent measurement of the uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BCVA), manifest refraction, vector analysis of astigmatic change, corneal topography, and corneal wavefront analysis at baseline and at every posttreatment visit. Three months postoperatively, a UDVA of 0.0 logMAR or better and manifest refraction spherical equivalent (MRSE) within ±0.5 diopters (D) did not differ across the TMR-, WFO-, and manifest TG-LASIK groups. However, the residual cylinder in the TMR group was significantly larger than that in the WFO and manifest TG groups. The magnitude of error in the TMR group measured using astigmatism vector analysis was significantly higher than that in the WFO and manifest TG groups. Although these three LASIK platforms achieved the predicted surgical outcomes, TMR-LASIK overcorrected astigmatism and showed a higher residual postoperative astigmatism compared with WFO- and manifest TG-LASIK.