Czech and Slovak Ophthalmology 79 Original article Comparison of Visual Acuity and Higher-Order Aberrations after Standard and Wavefront-Guided Myopic Femtosecond Lasik Anderle Radek Ventruba Jakub Skorkovská Šárka 30 1 2015 1 6

Purpose: To analyze and compare visual acuity, refractive outcomes and higher-order aberrations after standard and wavefront-guided Femto-LASIK at 1, 3, and 12 months postoperatively. Methods: Study of 95 consecutive eyes of myopic patients (-0.5 to -7.0 D), who underwent Femto-LASIK with standard ablation profile (STA) (49 eyes) or wavefront-guided ablation (WFG) (46 eyes) using femtosecond laser LDV Ziemer and excimer laser MEL 80 Zeiss with iris registration. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction and higher-order ocular aberrations (HOAs). HOAs were measured with Hartmann-Shack wavefront aberrometer WASCA, HOAs analyzed at 6 mm pupil, assessed total HOAs root mean square (RMS HOAs) and individual Zernike coefficients. Results: Preoperatively, there were no significant differences between STA and WFG groups in UDVA, CDVA, manifest refraction or HOAs. As compared with preoperative values, spherical aberration Z(4,0) increased by 0.24 μm in both groups and it is the main increasing factor of RMS HOAs (0.05 μm in STA group and 0.08 μm in WFG group). Safety and efficacy index is 1.0 in both ablation profiles. Postoperatively, median UDVA and CDVA achieved 1.2. No patient lost line of CDVA at 12 month postoperatively. All patients were within ± 0,5 D of emmetropia at 12 months. Significant differences were not found between STA and WFG in UDVA, CDVA, manifest refraction or HOAs at 1, 3 and 12 month. Conclusions: Both wavefront-guided and standard Femto-LASIK with LDV and MEL 80 platform have shown very good efficacy and safety. Myopic Femto-LASIK only slightly increases RMS HOAs, especially by induction of spherical aberration. Both methods have equivalent postoperative aberration score one year postoperatively.

 femtosecond LASIK higher-order aberrations wavefront-guided visual accuity. References Applegate, R.A., Marsasck, J.D., Ramos, R. et al.: Interaction between aberrations to improve or reduce visual performance. J Cataract Refract Surg, 2003; 29: 1487–1495. Applegate, R.A., Sarver, E.J., Khemsara, V.: Are all aberrations equal? J Refract Surg, 2002; 18: 556–562. Artal, P., Berrio, E., Guirao, A. et al.: Contribution of cornea and internal surfaces to the change of ocular aberratisafety of wavefront-guided refractive laser treatment: metaanalysis. J Cataract Refract Surg, 2011; 37(8): 1465–75. El Danasoury, A.M., Holladay, J., Waring, G.O. 3rd, et al.: A contralateral, randomized comparison of optimized prolate ablation and conventional LASIK for myopia with the NIDEK excimer laser platform. J Refract Surg, 2012 Jul; 28(7): 453–61. Fares, U., Suleman, H., Al-Aqaba, M.A. et al.: Efficacy, predictability, and Feng, Y., Yu, J., Wang, Q.: Meta-analy - sis of wavefront-guided vs. wavefront- -optimized LASIK for myopia. Optom Vis Sci, 2011; 88(12): 1463–1469. Franzco, M.L., Hodge, Ch.: Wavefront´s role in corneal surgery. Clinic Experimental Ophthal, 2005; 33: 199– Guirao, A., Williams, D.R., MacRae, S.M.: Effect of beam size on the expected benefit of customized laser refractive surgery. J Refract Surg, 2003; 19: 15–23. Huang, D., Arif, M.: Spot size and quality of scanning laser correction of higher- -order wavefront aberrations. J Cataract Refract Surg, 2002; 28: 407–16. Chalita, M.R., Chavala, S., Xu, M. et al.: Wavefront analysis in post-LASIK eyes and its correlation with visual symptoms, refraction and topography. Ophthalmology, 2004; 11: 447-453. Kanellopoulos, A.J., Asimellis, G.: Refractive and keratometric stability in high myopic LASIK with high-frequency femtosecond and excimer laser. J Refract Surg, 2013; 29(12): 832–837. Kermani, O., Schmiedt, K., Oberheide, U. et al.: Topographic and wavefront- -guided customized ablations with the NIDEK-EC5000CXII in LASIK for myopia. J Refract Surg, 2006; 22(8): 754–763. Moshirfar, M., Schliesser, J.A., Chang, J.C. et al.: Visual outcomes after wavefronttion, results, and limitations. J Refract Surg, 2012 Mar; 28(3): 224–32. Moshirfar, M., Hatch B.B., Chang J.C., et al.: Prospective, contralateral comparison of 120-μm and 90-μm LA- SIK flaps using the IntraLase FS60 femtosecondlaser. J Refract Surg. 2011 Apr;27(4):251-9. Mrochen, M., Keammerer, M., Mierdel, P. et al.: Increased higher-order aberrations after laser refractive surgery: a problem of subclinical decentration. J Cataract Refract Surg, 2001; 27: 362–369. Perez-Straziota, C.E., Randleman, J.B., Stulting, R.D.: Visual acuity and higher-order aberrations with wavefront-guided and wavefront-optimized laser in situ keratomileusis. J Cataract Refract Surg, 2010 Mar; 36(3): 437–41. Smadja, D., Reggiani-Mello, G., Santhiago, M.R., et al.: Wavefront ablation profiles in refractive surgery: descrip- Tomita, M., Waring, GO 4th, Magnago, T., et al.: Clinical results of using a high- -repetition-rate excimer laser with an optimized ablation profile for myopic correction in 10 235 eyes. J Cataract Refract Surg, 2013 Oct; 39(10): 1543–9. Venter, J.: Wavefront-guided custom ablation for myopia using the NIDEK NA- VEX laser system. J Refract Surg. 2008; 24(5): 487–493 Waheed, S., Chalita, M.R., Xu, M. et al.: Flap-induce and laser-induce ocular aberrations in a two-step procedure. J Refract Surg 2005; 21: 346–352. Yu, C.Q., Manche, E.E.: Comparison of 2 wavefront-guided excimer lasers for myopic laser in situ keratomileusis: one-year results. J Cataract Refract Surg. 2014; 40(3): 412–422. Zhang, J., Zhou, Y., Wang, N., et al.: Comparison of visual performance between conventional LASIK and wavefront-guided LASIK with iris-registration. Chin Med J, 2008; 121: 137–142. -guided photorefractive keratectomy and wavefront-guided laser in situ keratomileusis: Prospective comparison. J Cataract Refract Surg, 2010; 36: 1336–1343.