Corneal wavefront-guided ablation with the Schwind ESIRIS laser for myopia

PURPOSE: To evaluate the outcome of corneal wavefront-guided LASIK for the treatment of myopia and myopic astigmatism. METHODS: This study included 56 myopic virgin eyes of 28 patients with a mean spherical equivalent refraction of -4.40 +/- 1.83 diopters (D) (range: -1.25 to -9.75 D) and astigmatism < 2.50 D. The corneal wavefront aberrations were analyzed using a corneal topography system. The preoperative corneal wavefront aberration data obtained from the above analyses combined with manifest refraction were used to generate a customized ablation profile. The safety, efficacy, and predictability of the correction, contrast sensitivity, and corneal higher order wavefront aberrations were evaluated. RESULTS: At 1-year follow-up, the mean residual spherical equivalent refractive error was -0.15 +/- 0.3 D (range: 0 to -1.25 D) and mean cylinder was -0.54 +/- 0.34 D (range: 0 to -1.50 D). Ninety-five percent of eyes were in the residual refractive error range of +/- 0.50 D and uncorrected visual acuity improved by 1.00 D or better in 94% of eyes. The safety index and efficacy index were 1.13 and 0.92, respectively. After treatment, corneal higher order wavefront aberrations with a 6-mm pupil diameter increased significantly (paired sample t test, P < .01), and contrast sensitivity with glare had small reductions at high spatial frequencies. Changes in spherical-like aberration (R = 0.708, P < .001) and higher order wavefront aberration (R = 0.449, P = .001), except for coma-like aberration (P = .238), were positively correlated with the amount of achieved correction. CONCLUSIONS: Evaluation of clinical results showed that corneal wavefront-guided LASIK for the correction of myopia and myopic astigmatism was safe and effective. There was an increase in all higher order aberrations postoperatively.