Topography-guided vs Wavefront-optimized Surface Ablation for Myopia Using the WaveLight Platform: A Contralateral Eye Study

PURPOSE: To compare treatments with wavefront-optimized and topography-guided ablations. METHODS: This prospective, randomized, contralateral study comprised 40 eyes (20 patients) with low to moderate myopia with or without astigmatism that underwent topography-guided photorefractive keratectomy (PRK) (ALLEGRO Topolyzer, Alcon Laboratories Inc) in one eye and wavefront-optimized PRK (ALLEGRETTO WAVE software version 2.020 default treatment, Alcon Laboratories Inc) in the fellow eye. Visual acuity, refractive error, contrast sensitivity, and Orbscan (Bausch & Lomb) 3- and 5-mm corneal irregularities were measured preoperatively and 3 and 6 months postoperatively. The results were compared between the two eyes. RESULTS: In both groups, preoperative corrected distance visual acuity (CDVA) (0.03 +/- 0.09 logMAR for topography-guided and 0.01 +/- 0.06 logMAR for wavefront-optimized [P = .1]), 3-month postoperative uncorrected distance visual acuity (UDVA) (-0.01 +/- 0.03 logMAR for topography-guided and -0.01 +/- 0.03 logMAR for wavefront-optimized [P = .4]), and 6-month postoperative UDVA (0.01 +/- 0.03 logMAR for topography-guided and 0.0 +/- 0.01 logMAR for wavefront-optimized [P = .3]) were the same. All wavefront-optimized and 18 (90%) topography-guided eyes had UDVA of 20/20 or better. No significant differences were noted between groups in pre- and postoperative spherical and cylindrical refractive errors or corneal irregularity and contrast sensitivity measurements. Six months postoperatively, contrast sensitivity values at 3, 6, 12, and 18 cycles/degree were 5.7 +/- 0.7, 6.0 +/- 1.5, 6.1 +/- 1.3, and 5.5 +/- 1.5, respectively, in the topography-guided group, and 6.2 +/- 0.6, 6.4 +/- 1.2, 6.4 +/- 1.1, and 5.8 +/- 1.3, respectively, in the wavefront-optimized group (P = .3, P = .5, P = .4, and P = .6, respectively). CONCLUSIONS: Using the WaveLight excimer laser platform for PRK, CDVA and contrast sensitivity outcomes were statistically similar between the wavefront-optimized and topography-guided ablations in eyes with low to moderate myopia with and without astigmatism. [J Refract Surg. 2011;27(1):13-17.] doi:10.3928/1081597X-20100310-02