| Comparison of Changes in Higher-order Aberrations between Conventional and Wavefront-guided LASEK. |
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Sang Mok Lee, Min Joung Lee, Mee Kum Kim, Won Ryang Wee, Jin Hak Lee |
1Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea. kmk9@snu.ac.kr
2Artificial Eye Center of Clinical Research Institute, Seoul National University Hospital, Seoul, Korea. |
| 고식적인 라섹과 웨이브프론트 방식을 이용한 라섹 전후의 고위수차의 변화 비교 |
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이상목1,2,이민정1,2,김미금1,2,위원량1,2,이진학1,2 |
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Department of Ophthalmology, College of Medicine, Seoul National University1, Seoul, Korea Artificial Eye Center of Clinical Research Institute, Seoul National University Hospital2, Seoul, Korea |
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Correspondence:
Mee Kum Kim, M.D. |
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| Abstract |
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 micrometer. 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 micrometer to 0.49+/-0.16 micrometer (p=.001), 0.21+/-0.09 micrometer to 0.31+/-0.14 micrometer (p=.003), and 0.03+/-0.10 micrometer to 0.10+/-0.20 micrometer (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 micrometer to 0.46+/-0.14 micrometer (p=.004), 0.18+/-0.10 micrometer to 0.29+/-0.14 micrometer (p=.002), and 0.09+/-0.14 micrometer to 0.19+/-0.14 micrometer (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. |
| Key Words:
Case control study;Higher order aberrations;LASEK;Postoperative change;Wavefront |
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