A prospective, randomized, fellow eye comparison of Wavelight® Allegretto wave® Eye-Q versus VISX CustomVue™; STAR S4 IR™; in laser in situ keratomileusis (LASIK): Analysis of visual outcomes and higher order aberrations

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Abstract

Purpose: To compare outcomes in visual acuity, refractive error, higher-order aberrations (HOAs), contrast sensitivity, and dry eye in patients undergoing laser in situ keratomileusis (LASIK) using wavefront (WF) guided VISX CustomVue and WF optimized WaveLight Allegretto platforms. Methods: In this randomized, prospective, single-masked, fellow eye study, LASIK was performed on 44 eyes (22 patients), with one eye randomized to WaveLight Allegretto, and the fellow eye receiving VISX CustomVue. Postoperative outcome measures at 3 months included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive error, root-mean-square (RMS) value of total and grouped HOAs, contrast sensitivity, and Schirmers testing. Results: Mean values for UDVA (logMAR) were -0.067 ± 0.087 and -0.073 ± 0.092 in the WF optimized and WF guided groups, respectively (P = 0.909). UDVA of 20/20 or better was achieved in 91% of eyes undergoing LASIK with both lasers while UDVA of 20/15 or better was achieved in 64% of eyes using the Allegretto platform, and 59% of eyes using VISX CustomVue (P = 1.000). In the WF optimized group, total HOA increased 4% (P = 0.012), coma increased 11% (P = 0.065), and spherical aberration increased 19% (P = 0.214), while trefoil decreased 5% (P = 0.490). In the WF guided group, total HOA RMS decreased 9% (P = 0.126), coma decreased 18% (P = 0.144), spherical aberration decreased 27% (P = 0.713) and trefoil decreased 19% (P = 0.660). One patient lost one line of CDVA secondary to residual irregular astigmatism. Conclusion: Both the WaveLight Allegretto and the VISX CustomVue platforms had equal visual and safety outcomes. Most wavefront optimized HOA values trended upward, with a statistically significant increase in total HOA RMS. Eyes treated with the WF guided platform showed a decreasing trend in HOA values. © 2011 Moshirfar et al, publisher and licensee Dove Medical Press Ltd.

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Moshirfar, M., Betts, B. S., Churgin, D. S., Hsu, M., Neuffer, M., Sikder, S., … Mifflin, M. D. (2011). A prospective, randomized, fellow eye comparison of Wavelight® Allegretto wave® Eye-Q versus VISX CustomVueTM; STAR S4 IRTM; in laser in situ keratomileusis (LASIK): Analysis of visual outcomes and higher order aberrations. Clinical Ophthalmology, 5(1), 1339–1347. https://doi.org/10.2147/opth.s24316

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