Outcomes of topography-guided versus wavefront-optimized laser in situ keratomileusis for myopia in virgin eyes

J Cataract Refract Surg. 2016 Sep;42(9):1302-1311. doi: 10.1016/j.jcrs.2016.06.035.


Purpose: To compare the outcomes of topography-guided and wavefront-optimized treatment in patients having laser in situ keratomileusis (LASIK) for myopia.

Setting: Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Design: Prospective contralateral-eye case study.

Methods: Patients had topography-guided LASIK in 1 eye and wavefront-optimized LASIK in the contralateral eye using the Customized Refractive Surgery Master software and Mel 80 excimer laser. Refractive (residual manifest refraction spherical equivalent [MRSE], higher-order aberrations [HOAs]), and visual (uncorrected distance visual acuity [UDVA] and photopic and mesopic contrast sensitivity) outcomes were prospectively analyzed 6 months postoperatively.

Results: The study comprised 35 patients. The UDVA was 0.0 logMAR or better and the postoperative residual MRSE was ±0.50 diopter in 94.29% of eyes in the topography-guided group and 85.71% of eyes in the wavefront-optimized group (P = .09). More eyes in the topography-guided group than in the wavefront-optimized group had a UDVA of -0.1 logMAR or better (P = .04). Topography-guided LASIK was associated with less deterioration of mesopic contrast sensitivity at higher spatial frequencies (12 cycles per degree [cpd] and 18 cpd) and lower amounts of induced coma (P = .04) and spherical aberration (P = .04). Less stromal tissue was ablated in the topography-guided group (mean 61.57 μm ± 16.23 [SD]) than in the wavefront-optimized group (mean 79.71 ± 14.81 μm) (P < .001).

Conclusion: Although topography-guided LASIK and wavefront-optimized LASIK gave excellent results, topography-guided LASIK was associated with better contrast sensitivity, lower induction of HOAs, and a smaller amount of tissue ablation.

Financial disclosure: None of the authors has a financial or proprietary interest in any material or method mentioned.

MeSH terms

  • Astigmatism
  • Corneal Wavefront Aberration
  • Humans
  • India
  • Keratomileusis, Laser In Situ*
  • Lasers, Excimer
  • Myopia / surgery*
  • Prospective Studies
  • Refraction, Ocular
  • Treatment Outcome