Selective corneal wavefront-guided and wavefront-optimized myopic LASIK using high-repetition-rate excimer laser: contralateral eye study

PURPOSE: To compare the refractive, visual, and higher-order aberration (HOA) outcomes between selective corneal wavefront-guided (CW) and aberration-free (AF) ablation profiles in eyes undergoing laser-assisted in situ keratomileusis (LASIK) using a high-repetition-rate excimer laser platform. SETTING: Hong Kong Sanatorium & Hospital, Hong Kong Special Administrative Region. DESIGN: Retrospective, contralateral eye study. METHODS: Patients who underwent myopic LASIK using the AMARIS 1050RS excimer laser with one eye treated with CW and the other with AF ablation profile were included. In the CW group, only vertical coma (Z[3,-1]), horizontal coma (Z[3,1]), and spherical aberration (SA) (Z[4,0]) that reached a clinically relevant level (≥0.25 defocus equivalent) were treated. Subgroup analysis was performed based on the HOA components involved. RESULTS: 85 patients were included. Postoperative astigmatism and corrected distance visual acuity were comparable between the CW and AF groups overall and in all treatment subgroups ( P > .05). The postoperative sphere was more hyperopic in the CW group than that in the AF group, with differences of 0.18 D overall and 0.26 D in the SA-treated subgroup (both P < .001). None of the eyes (0%) lost 2 or more lines. Postoperative root-mean-square HOA and individual HOA components generally showed less induction or greater reduction in the CW group than in the AF group. CONCLUSIONS: LASIK with CW and AF ablation using the AMARIS 1050 RS excimer laser was safe and yielded satisfactory visual outcomes, with CW ablation inducing less or reducing more HOAs than AF ablation. SA treatment-related hyperopic shift was observed with CW ablation.