Edward Manche

Publication Details

  • One-Year Outcomes from a Prospective, Randomized, Eye-to-Eye Comparison of Wavefront-Guided and Wavefront-Optimized LASIK in Myopes. Ophthalmology Sáles, C. S., Manche, E. E. 2013


    OBJECTIVE: To compare wavefront (WF)-guided and WF-optimized LASIK in myopes. DESIGN: Prospective, randomized, eye-to-eye study. PARTICIPANTS: A total of 72 eyes of 36 participants with myopia with or without astigmatism. METHODS: Participants were randomized to receive WF-guided or WF-optimized LASIK with the WaveLight Allegretto Eye-Q 400-Hz excimer laser platform (Alcon, Inc., Hüenberg, Switzerland). LASIK flaps were created using the 150-kHz IntraLase iFS (Abbott Medical Optics, Santa Ana, CA). Evaluations included measurement of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), <5% and <25% contrast sensitivity, and WF aberrometry. Patients also completed a validated questionnaire detailing symptoms on a quantitative scale. MAIN OUTCOME MEASURES: Safety, efficacy, predictability, refractive error, UDVA, CDVA, contrast sensitivity, and higher-order aberrations (HOAs). RESULTS: The frequency with which the WF-guided and WF-optimized groups achieved postoperative UDVA of ?20/16 or ?20/20 and the frequency with which the groups lost 1 or 2 or more lines or maintained their preoperative CDVA were not statistically different from each other (all P?>?0.05). The frequency with which the WF-guided group attained a refractive error within ±0.25 diopters of emmetropia was higher than in the WF-optimized group (67.6%, 95% confidence interval [CI], 50.4-84.8 vs. 41.2%, 95% CI, 23.2-59.2; P = 0.03). The WF-guided group's mean UDVA was better than the WF-optimized group's UDVA by approximately 1 Early Treatment Diabetic Retinopathy Study line (-0.17±0.11 logarithm of the minimum angle of resolution [logMAR], slightly <20/12 Snellen vs. -0.13±0.12, slightly >20/16; P = 0.05). There were no statistically significant differences in contrast sensitivity, astigmatism, coma, or higher-order root mean square error between the groups (all P?>?0.05), but the WF-guided group had less trefoil compared with the WF-optimized group (0.14±0.07 vs. 0.20±0.09; P??0.05). CONCLUSIONS: Wavefront-guided and WF-optimized LASIK using the Alcon WaveLight Allegretto Eye-Q 400-Hz excimer laser platform provide similar results in myopic patients; however, the WF-guided approach may yield small gains in visual acuity, predictability, and HOAs. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

    View details for PubMedID 23778091

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