Comparison of 2 wavefront-guided excimer lasers for myopic laser in situ keratomileusis: one-year results.

Purpose: To compare laser in situ keratomileusis (LASIK) outcomes between 2 wavefront-guided excimer laser systems in the treatment of myopia.

Setting: University eye clinic, Palo Alto, California, USA.

Design: Prospective comparative case series.

Methods: One eye of patients was treated with the Allegretto Wave Eye-Q system (small-spot scanning laser) and the fellow eye with the Visx Star Customvue S4 IR system (variable-spot scanning laser). Evaluations included measurement of uncorrected visual acuity, corrected visual acuity, and wavefront aberrometry.

Results: One hundred eyes (50 patients) were treated. The mean preoperative spherical equivalent (SE) refraction was -3.89 diopters (D) ± 1.67 (SD) and -4.18 ± 1.73 D in the small-spot scanning laser group and variable-spot scanning laser group, respectively. There were no significant differences in preoperative higher-order aberrations (HOAs) between the groups. Twelve months postoperatively, all eyes in the small-spot scanning laser group and 92% in the variable-spot scanning laser group were within ±0.50 D of the intended correction (P = .04). At that time, the small-spot scanning laser group had significantly less spherical aberration (0.12 versus 0.15) (P = .04) and significantly less mean total higher-order root mean square (0.33 μm versus 0.40 μm) (P = .01). Subjectively, patients reported that the clarity of night and day vision was significantly better in the eye treated with the small-spot scanning laser.

Conclusions: The predictability and self-reported clarity of vision of wavefront-guided LASIK were better with the small-spot scanning laser. Eyes treated with the small-spot scanning laser had significantly fewer HOAs.