Abstract | PURPOSE: To determine the impact of wavefront-guided LASIK for myopia with or without astigmatism on high and low contrast best spectacle-corrected visual acuity (BSCVA), photopic and mesopic contrast sensitivity, and higher order aberrations. METHODS: Bilateral wavefront-guided LASIK ( LADAR-Vision4000; Hansatome microkeratome) was performed on 324 eyes (162 patients) with a mean spherical manifest refraction of -2.84 +/- 1.35 diopters (D) (range: -0.25 to -6.50 D) and astigmatism of -0.81 +/- 0.74 D (range: 0 to -4.00 D). Mean age was 37.7 +/- 9.3 years (range: 20 to 60 years). Best spectacle-corrected visual acuity and contrast sensitivity were assessed using ETDRS charts and vertical sinusoidal gratings, respectively. Higher order aberrations were measured using a Shack-Hartmann wavefront sensor, analyzed across a 5-mm pupil. Repeated measures and post hoc analyses determined statistical significance (P < .0025). Only right eyes were analyzed. RESULTS: One hundred thirty-six eyes (84%) had uncorrected visual acuity of 20/20 or better 6 months postoperative; 80.9% (131 eyes) were within +/- 0.50 D of attempted correction. Statistically significant postoperative improvements were noted in high and low contrast BSCVA (both P < or = .001); in photopic contrast sensitivity at 3, 6, and 12 cycles per degree (cpd); and in mesopic contrast sensitivity at 12 and 18 cpd (all P < .001). With respect to higher order aberrations, a statistically significant change was seen in Zernike coefficients Z3(-1), Z3(1), Z3(-3), Z3(3), and Z4(4) following surgery (range of mean absolute change: 0.042 to 0.142 microm; all P < or = .001). All increased in magnitude except for Z3(-3), which decreased. CONCLUSIONS: Despite an increase in higher order aberrations, wavefront-guided LASIK yields excellent visual acuity and contrast sensitivity. Spherical aberration, which increases the most following non-wavefront-guided LASIK, showed no significant change.
|
Authors | Nancy J Keir, Trefford Simpson, Lyndon W Jones, Desmond Fonn |
Journal | Journal of refractive surgery (Thorofare, N.J. : 1995)
(J Refract Surg)
Vol. 25
Issue 6
Pg. 524-33
(06 2009)
ISSN: 1081-597X [Print] United States |
PMID | 19603620
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
|
Topics |
- Adult
- Astigmatism
(surgery)
- Contrast Sensitivity
(physiology)
- Corneal Topography
- Female
- Humans
- Keratomileusis, Laser In Situ
(methods)
- Lasers, Excimer
(therapeutic use)
- Male
- Middle Aged
- Myopia
(physiopathology, surgery)
- Prospective Studies
- Visual Acuity
(physiology)
- Young Adult
|