Higher-Order Aberrations After Ray-Tracing-Guided Vs. Wavefront-Optimized Laser In Situ Keratomileusis: Contralateral-Eye Comparison
Published 2025 - 43rd Congress of the ESCRS
Reference: FP02.08 | Type: Free paper | DOI: 10.82333/md0z-0r31
Authors: See Teng Tan* 1 , Shimna Prasad 2 , Shayne Tan 1 , Monisha E Nongpiur 3
1Training and Education,Singapore National Eye Center,Singapore,Singapore, 2Singapore Eye Research Institute,Singapore,Singapore, 3Glaucoma Department,Singapore National Eye Center,Singapore,Singapore;Singapore Eye Research Institute,Singapore,Singapore
Purpose
Intraindividual comparison of total ocular higher-order aberrations (HOAs) after ray-tracing-guided laser in situ keratomileusis (LASIK) and wavefront-optimized LASIK.
Setting
International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
Methods
Prospective, randomized, eye-to-eye comparison. Thirty patients (sixty eyes) with myopia and myopic astigmatism underwent ray-tracing-guided wavelight plus (Alcon) LASIK in one eye and wavefront-optimized LASIK in the fellow eye. The study assessed root-mean-square (RMS) of total HOAs, primary spherical aberration, RMS coma and RMS trefoil at 1 month and 3 months after ray-tracing-guided LASIK and wavefront-optimized LASIK. The predefined endpoint was the treatment-induced change (3 months postoperative - preoperative) in HOAs at the 6-mm analysis zone.
Results
The mean change (± standard deviation) in RMS of total HOAs was 0.00±0.15µm after wavelight plus (p=0.758) and 0.11±0.12µm after wavefront-optimized LASIK (p<0.001). Spherical aberration decreased by an average of 0.07±0.13µm after wavelight plus (p=0.012) and increased by 0.06±0.09µm after wavefront-optimized treatment (p<0.001). Changes in coma and trefoil were 0.02±0.15µm (p=0.474) and -0.02±0.10µm (p=0.225) after wavelight plus, while after wavefront-optimized LASIK they were respectively, 0.10±0.13µm (p<0.001) and 0.02 ± 0.06µm (p=0.058). In comparison to wavefront-optimized LASIK, eyes treated with wavelight plus had lower spherical aberration (p<0.001), coma (p=0.012), trefoil (p=0.023) and overall HOAs (p<0.001).
Conclusions
Wavefront-optimized LASIK increased total HOAs. We detected no statistically significant change after wavelight plus. Ray-tracing-guided LASIK resulted in lower postoperative HOAs than wavefront-optimized LASIK.