Evaluation of visual and refractive outcomes of wavefront optimized versus wavefront guided laser-assisted in situ keratomileusis in patients with myopia and myopic astigmatism

Purpose The aim of this study was to compare the visual and refractive outcomes of wavefront optimized (WFO) ablations with wavefront guided (WFG) ablations in patients with myopia and myopic astigmatism. Patients and methods Two consecutive groups of eyes were treated for myopia and myopic astigmatism with laser insitu keratomileusis. One group was treated with WFO ablation, and the other group was treated with WFG ablation. Refractive evaluation (efficacy, safety, predictability, accuracy, stability, and refractive astigmatism), higher‑order aberrations (HOAs), and contrast sensitivity were analyzed preoperatively and at 1, 3, and 6 months postoperatively. Results The WFO ablation group comprised 20 eyes of 11 patients who showed a change in the mean spherical equivalent refraction from − 3.34 ± 1.64 D preoperatively to − 0.21 ± 0.30 D at 6 months postoperatively, and the WFG ablation group comprised 34 eyes of 17 patients who showed a change in the mean spherical equivalent refraction from − 3.54 ± 1.50 D preoperatively to − 0.23 ± 0.57 D at 6 months postoperatively. A statistically significant difference was found when comparing within the group preoperatively versus 6 months postoperatively as regards contrast sensitivity, HOAs, trefoil root mean square (RMS), and spherical aberration. However, there was no significant difference in induced coma and spherical aberration RMS within each group preoperatively and at 6 months postoperatively. A statistically significant difference was found when comparing the two groups at 6 months postoperatively with respect to contrast sensitivity, induced HOA RMS, induced trefoil RMS, and spherical aberration. There was no significant difference between the two groups, except for induced coma and spherical aberration RMS. Conclusion Both the WFG group and the WFO showed comparable accuracy, efficacy, and safety with nearly equal induction of all HOAs