Comparative analysis of the efficacy of astigmatic correction after wavefront-guided and wavefront-optimized LASIK in low and moderate myopic eyes

AIM: To evaluate and compare the efficacy of the astigmatic correction achieved with laser in situ keratomileusis(LASIK) in eyes with myopic astigmatism using wavefront-guided(WFG) and wavefront-optimized(WFO) ablation profiles.METHODS: Prospective study included 221 eyes undergoing LASIK: 99 and 122 eyes with low and moderate myopic astigmatism(low and moderate myopia groups).Two subgroups were differentiated in each group according to the ablation profile: WFG subgroup,109 eyes(45/64,low/moderate myopia groups) treated using the Advanced Custom Vue platform(Abbott Medical Optics Inc.),and WFO subgroup,112 eyes(54/58,low/moderate myopia groups) treated using the EX-500 platform(Alcon).Clinical outcomes were evaluated during a 6-month follow-up,including a vector analysis of astigmatic changes.RESULTS: Significantly better postoperative uncorrected visual acuity and efficacy index was found in the WFG subgroups of each group(P≤0.041).Postoperative spherical equivalent and cylinder were significantly higher in WFO subgroups(P≤0.003).In moderate myopia group,a higher percentage of eyes with a postoperative cylinder ≤0.25 D was found in the WFG subgroup(90.6% vs 65.5%,P=0.002).In low and moderate myopia groups,the difference vector was significantly higher in the WFO subgroup compared to WFG(P<0.001).In moderate myopia group,the magnitude(P=0.008) and angle of error(P<0.001) were also significantly higher in the WFO subgroup.Significantlyless induction of high order aberrations were found with WFG treatments in both low and moderate myopia groups(P≤0.006).CONCLUSION: A more efficacious correction of myopic astigmatism providing a better visual outcome is achieved with WFG LASIK compared to WFO LASIK.