Wavefront Optimized Versus Custom-Q in Eyes with Myopia/Myopic Astigmatism Submitted to LASER In Situ Keratomileusis
DOI:
https://doi.org/10.48560/rspo.33131Keywords:
Astigmatism/surgery, Keratomileusis, Laser In Situ, Lasers, Excimer, Myopia/surgery, Refraction, OcularAbstract
Purpose: To compare the Custom-Q and Wavefront-optimized profiles in eyes with myopia or myopic astigmatism submitted to Femtosecond LASER in situ keratomileusis (LASIK).
Methods: Retrospective study of eyes submitted to Femtosecond LASER in situ keratomileusis (LASIK) ablation for myopia or myopic astigmatism, with the Custom-Q and Wavefront Optimized profiles. Root mean square higher order aberrations, spherical aberration, 90º coma, 180º coma, and 0º trefoil were evaluated in the total and anterior cornea (Zernike Polynomial analysis, Pentacam HR®). Vision quality was assessed with the HD Analyzer® (Ocular Dispersion Index and Modular Transfer Function). All parameters were evaluated before, and 1 and 6 months after surgery. For the Custom-Q group, the preoperative front mean 6 mm Q-value was used as target.
Results: Each group included 57 eyes of 30 patients. Both groups achieved similar good visual and refractive outcomes. One month after surgery, there was an increase in the root mean square higher order aberrations (p<0.001), without further changes (p>0.966). The spherical aberration increased in both groups at month 1 (p<0.018). There was a tendency for a superior increase of the spherical aberration in the Wavefront Optimized group at month 1 (p=0.083) and of the anterior 90º coma in the Custom-Q (p=0.084) group. However, the global variation (preoperative versus month 6) was similar for both aberrations (p=0.219 and p=0.632, respectively). There was an increase in the Q-value at month 1 in both groups (p<0.001), without differences between groups (p=0.105). The variation was similar in both groups comparing the pre-operative values with month 6 (p=0.630). There were no significant changes in the Ocular Dispersion Index in the Custom-Q (p=0.304) and Wavefront-optimized groups (p=0.468). After correcting for baseline differences, there were no significant differences in the Modular Transfer Function values between groups (p>0.174).
Conclusion: Both profiles led to comparably good refractive and visual outcomes. The Custom-Q profile seems to show a tendency to induce less spherical aberration and more anterior 90º coma in the first month. However, the global variation after 6 months was similar between groups. The variation of the asphericity was similar between groups.
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Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123:1036-42. doi: 10.1016/j.ophtha.2016.01.006.
Koller T, Isell HP, Hafezi F, Mrochen M, Seiler T. Q-factor customized ablation profile for the correction of myopic astigmatism. J Cataract Refract Surg. 2006;32:584-9. doi:10.1016/j.jcrs.2006.01.049
Ghoreishi SM, Naderibeni A, Peyman A, Rismanchian A, Eslami F. Aspheric Profile versus Wavefront-Guided Ablation Photorefractive Keratectomy for the Correction of Myopia using the Allegretto Eye Q. Eur J Ophthalmol. 2009;19:544-53. doi:10.1177/112067210901900405
Gao H, Miles TP, Troche R, Murdoch DM, Koefeed VF, Cason JB. Quality of Vision Following LASIK and PRK-MMC for Treatment of Myopia. Mil Med. 2022;187:e1051-e1058. doi:10.1093/milmed/uasb071
Myrowitz EH, Chuck RS. A comparison of wavefront-optimized and wavefront-guided ablations. Curr Opin Ophthalmol. 2009;20:247-50. doi:10.1097/ICU.0b013e32832a2336
Chan WW, Edwards MH, Woo GC, Woo VCP. Contrast sensitivity after laser in situ keratomileusis: One-year follow-up. J Cataract Refract Surg. 2002;28:1774-9. doi:10.1016/S0886-3350(02)01499-2
Nassiri N, Safi S, Aghazade Amiri M, Sheibani K, Safi H, Panahi N, et al. Visual outcome and contrast sensitivity after photorefractive keratectomy in low to moderate myopia: wavefront-optimized versus conventional methods. J Cataract Refract Surg. 2011;37:1858-64. doi: 10.1016/j.jcrs.2011.05.023
Tawfik A, Eid AM, Hasanen R, Moffah IA. Q-value customized ablation (custom-Q) versus wavefront optimized ablation for primary myopia and myopic astigmatism. Int Ophthalmol. 2014;34:259-62. doi:10.1007/s10792-013-9828-1
Mostafa MM, Abdelmotaal H, Abdelazeem K, Goda I, Abdel-Radi M. Q-value customized versus wavefront-optimized ablation in femtosecond laser-assisted LASIK for myopia and myopic astigmatism: a prospective contralateral comparative study. Eye Vis. 2022;9:43. doi:10.1186/s40662-022-00312-3
Holladay JT. Proper method for calculating average visual acuity. J Refract Surg. 1997;13:388-91. doi:10.3928/1081-597X-19970701-16
Arba-Mosquera S, Hollerbach T. Ablation resolution in laser corneal refractive surgery: the dual fluence concept of the AMARIS platform. Adv Opt Technol. 2010;2010:1-13. doi:10.1155/2010/538541
Gatinel D, Malet J, Hoang-Xuan T, Azar DT. Analysis of customized corneal ablations: theoretical limitations of increasing negative asphericity. Invest Ophthalmol Vis Sci. 2002;43:941-8.
Rosa N, De Bernardo M, Lanza M, Borrelli M, Fusco F, Flagello A. Corneal aberrations before and after photorefractive keratectomy. J Optom. 2008;1:53-8. doi:10.3921/joptom.2008.53
Hersh PS, Shah SI, Holladay JT. Corneal asphericity following excimer laser photorefractive keratectomy. Summit PRK Topography Study Group. Ophthalmic Surg Lasers. 1996;27:S421-428.
Oliver KM, Hennenger RP, Corbett MC, O'Brart DP, Verma S, Marshall J, et al. Corneal optical aberrations induced by photorefractive keratectomy. J Refract Surg. 1997;13:246-54. doi:10.3928/1081-597X-19970501-10
Hong X, Thibos LN. Longitudinal evaluation of optical aberrations following laser in situ keratomileusis Surgery. J Refract Surg. 2000;16:S647-50. doi:10.3928/1081-597X-20000901-32
Srivannaboon S, Reinstein DZ, Archer TJ, Chansue E. Spherical aberration from myopic excimer laser ablation for aspheric and non-aspheric profiles. Optom Vis Sci. 2012;89:1211-8. doi:10.1097/OPX.0b013e318263c2b2
Manns F, Ho A, Parel JM, Culbertson W. Ablation profiles for wavefront-guided correction of myopia and primary spherical aberration. J Cataract Refract Surg. 2002;28:766-74. doi:10.1016/S0886-3350(01)01322-0
Simão JM, Osório I, Neves E, Raimundo M, Rosa A, Quadrado MJ, et al. Custom-Q versus Wavefront-Optimized photorefractive keratectomy for myopia with or without astigmatism correction. Rev Soc Port Ofalmol.2021:133-40. doi:10.48560/PSPO.23306
Feng Y, Yu J, Wang Q. Meta-Analysis of Wavefront-Guided vs. Wavefront-Optimized LASIK for myopia. Optom Vis Sci. 2011;88:1463-9. doi:10.1097/OPX.0b013e3182333a50
Wavefront-optimized Versus Wavefront-guided LASIK for myopic astigmatism with the ALLEGRETTO WAVE: three-month results of a prospective FDA Trial. J Refract Surg. 2008;24:1081597X-20080401-20080420. doi:10.3928/1081597X-20080401-20
Razmjou H, Peyman A, Moshfeghi S, Kateb H, Naderan M. A comparison between wavefront-optimized and wavefront-guided photorefractive keratectomy in patients with moderate-to-high astigmatism: A randomized clinical trial. J Curr Ophthalmol. 2022;34:194-199. doi:10.4103/joco.joco_18_21
Duarte M. Wavelight@EX500: Treatment Options.
Gonzalez-Cruces T, Villarrubia A, Sánchez Ventosa Á, Palacin Miranda E, Castillo Eslava R, Gomera Martinez A, et al. Comparison between the Wavefront-Optimized and Custom-Q aspheric ablation profiles in myopic eyes with two different Q-targets: a contralateral eye study. J Refract Surg. 2022;38:698-707. doi: 10.3928/1081597X-20221005-01.
Stojanovic A, Wang L, Jankov MR, Nitter TA, Wang Q. Wavefront optimized versus custom-Q treatments in surface ablation for myopic astigmatism with the WaveLight ALLEGRETTO laser. J Refract Surg. 2008;24:779-89. doi: 10.3928/1081597X-20081001-03.
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