<p>A Prospective Comparison of Wavefront-Guided LASIK versus Wavefront-Guided PRK After Previous Keratorefractive Surgery</p>

Abstract

Purpose: To compare the results of retreatment with wavefront-guided LASIK versus wavefront-guided PRK for residual refractive error following previous myopic keratorefractive surgery. Methods: In this prospective study, 32 eyes of 28 patients after prior myopic keratorefractive surgery underwent retreatment with flap-lift wavefront-guided LASIK (n = 12) or wavefront-guided PRK (n = 20) for residual refractive error. Safety, efficacy, predictability, and wavefront outcomes were evaluated. Results: At last follow-up, both LASIK and PRK retreatment resulted in similar improvement in visual acuity with respective mean ± standard deviation (SD) uncorrected distance visual acuity of −0.07 ± 0.11 logMAR and −0.06 ± 0.13 logMAR (p = 0.87). In the study, 16.7% of LASIK and 33.3% of PRK eyes gained one or more lines of best-corrected distance visual acuity (CDVA), while 16.7% and 9.5% of eyes lost one or more lines of CDVA with LASIK and PRK, respectively. One hundred % of LASIK eyes and 89.5% of PRK eyes were within ± 0.50 diopters of emmetropia. Wavefront analysis demonstrated similar reductions in total RMS error higher-order aberrations (p = 0.84) with no difference in coma, trefoil, or spherical aberration between eyes undergoing LASIK or PRK retreatment. Conclusion: Wavefront-guided LASIK and wavefront-guided PRK following previous keratorefractive surgery demonstrate similar safety, efficacy, and predictability with comparable wavefront outcomes.

Laser-Assisted In Situ Keratomileusis (LASIK) Enhancement for Residual Refractive Error after Primary LASIK

“…Prior studies evaluating LASIK enhancements after primary LASIK have been published ( Table 3 ) [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. At 12 months, 86% and 99% of our eyes had a UDVA of 20/20 or better and 20/40 or better, respectively.…”

“…At 12 months, 86% and 99% of our eyes had a UDVA of 20/20 or better and 20/40 or better, respectively. In comparison, 21.1–93.3% of eyes in previous studies had a UDVA of 20/20 or better while 88.2–100% of eyes had a UDVA of 20/40 or better [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. Our results showed 4% of eyes that lost one line of CDVA and 0.6% of eyes that lost two or more lines at 12 months postoperatively.…”

“…Our results showed 4% of eyes that lost one line of CDVA and 0.6% of eyes that lost two or more lines at 12 months postoperatively. Existing literature shows 0–28% of eyes that lost one line and 0–31.8% that lost two or more lines of CDVA [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. At 12 months, there were 93% of eyes within ±0.50 D of the intended target and 99% within ±1.00 D in our study.…”

“…At 12 months, there were 93% of eyes within ±0.50 D of the intended target and 99% within ±1.00 D in our study. Other studies show 46.4–100% of eyes within ±0.50 D of the target and 63.4–100% within ±1.00 D [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ].…”

Intra-Operative Discomfort in Photorefractive Keratectomy

“…However, recent studies and systematic reviews comparing LASIK and PRK, and their variants aided by wavefront technologies have not proved significant differences in outcomes with respect to visual acuity, spherical aberration (SA), or higher-order aberrations (HOAs). [11][12][13][14][15][16][17] As such, PRK is likely to remain a popular choice for refractive surgery in the Air Force.…”