Comparison of wavefront-optimized and corneal wavefront-guided transPRK for high-order aberrations (>0.35 μm) in myopia.

PURPOSE: To compare the clinical outcomes, mainly including contrast sensitivity and high-order aberrations (HOAs), between wavefront-optimized (WFO) and corneal wavefront-guided (CWFG) transepithelial photorefractive keratectomy (transPRK) for preoperative HOAs >0.35 μm.

SETTING

Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong, China.

DESIGN

Prospective randomized controlled study.

METHODS

71 patients with preoperative total ocular and corneal aberrations >0.35 μm who underwent transPRK for the treatment of myopia and myopic astigmatism were randomly divided into the aberration optimization mode group (WFO group; 36 eyes) and the corneal wavefront-guided mode group (CWFG group; 35 eyes). Preoperative and postoperative visual outcome, refraction, contrast sensitivity, and HOAs were compared.

RESULTS

71 patients (71 eyes) who underwent transPRK were selected. The CWFG group had significantly lower total HOAs and coma values in the corneal aberration compared with the WFO group at 3 ( P = .009; P < .001) and 6 months postoperatively ( P = .006; P < .001). In addition, the CWFG group had significantly lower total HOAs and coma values in the whole-eye aberration compared with the WFO group at 3 ( P = .044; P = .004) and 6 months postoperatively ( P = .026; P = .001). The CWFG group had significantly better improvement in contrast sensitivity than the WFO group at spatial frequencies of 3 cycles per degree (cpd), 6 cpd, 12 cpd, and 18 cpd ( P = .005, P = .007, P = .001, and P < .001, respectively).

CONCLUSIONS

CWFG transPRK is associated with better visual and refractive outcomes and less HOAs than WFO transPRK in eyes with preoperative aberrations >0.35 μm.