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KMID : 0360220070480081028
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Journal of the Korean Ophthalmological Society
2007 Volume.48 No. 8 p.1028 ~ p.1035
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Comparison of Changes in Higher-order Aberrations between Conventional and Wavefront-guided LASEK
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Lee Sang-Mok
Lee Min-Joung
Kim Mee-Kum
Wee Won-Ryang
Lee Jin-Hak
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Abstract
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Purpose: To evaluate the postoperative higher-order aberrations (HOAs) and factors affecting postoperative changes in HOAs in eyes that underwent wavefront-guided LASEK (laser-assisted subepithelial keratectomy), compared with the eyes that underwent conventional LASEK.
Methods: We reviewed the medical records of 221 patients who had undergone LASEK or wavefront guided LASEK with VISX WaveScan and VISX Star S4 eximer laser by a single surgeon (427 total eye operations). We matched 29 eyes of the LASEK and the wavefront LASEK groups (58 eyes total) according to the guideline: preoperative refractive power differences must be within 1 diopter and preoperative root-mean-square (RMS) of total HOAs differences must be within 0.01 μm. Preoperative wavefront aberrations and two-months postoperative wavefront aberrations and associated factors were compared and analyzed.
Results: Postoperative total HOAs, comas, and spherical aberrations increased significantly from 0.36±0.10 μm to 0.49±0.16 μm (p=.001), 0.21±0.09 μm to 0.31±0.14 μm (p=.003), and 0.03±0.10 μm to 0.10±0.20 μm (p=.043), respectively, in the conventional LASEK group. In the wavefront LASEK group, postoperative HOAs, comas, and spherical aberrations significantly increased from 0.36±0.10 μm to 0.46±0.14 μm (p=.004), 0.18±0.10 μm to 0.29±0.14 μm (p=.002), and 0.09±0.14 μm to 0.19±0.14 μm (p=.006), respectively. There were no significant differences in HOAs between the two groups. A strong negative correlation between preoperative total HOAs and a multiple of increase in total HOAs postoperatively was found, with the negative correlation being stronger in the wavefront-guided LASEK group (Pearson`s correlation coefficient =-0.697, p<.001) than in the LASEK group (Pearson`s correlation coefficient =-0.632, p<.001).
Conclusions: There were no significant decreases in HOAs in the eyes that underwent wavefront-guided LASEK compared with the matched control eyes of patients that underwent conventional LASEK. Analyzing the tendency of a multiple of increase in total HOAs according to the preoperative HOAs, it suggests that the wavefront-guided LASEK may be more effective in suppressing an increase in total HOAs in the eyes with higher preoperative HOAs.
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KEYWORD
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Case control study, Higher order aberrations, LASEK, Postoperative change, Wavefront
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