Comparison of clinical and patient-reported outcomes of contralateral topography-guided vs wavefront-guided LASIK
Abstract
Purpose: To compare 6-month visual and patient-reported outcomes between topography-guided (TG) using Contoura with Phorcides and wavefront-guided (WFG) LASIK using iDesign 2.0 laser-assisted in situ keratomileusis (LASIK).
Setting: Joint Warfighter Refractive Surgery Center, Lackland Air Force Base, Texas.
Design: Prospective, double-blind, randomized.
Methods: 66 participants receive TG-LASIK in one eye and WFG-LASIK in the contralateral eye. Preoperative and postoperative assessments included uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), manifest refraction, higher-order aberrations (HOAs), Schirmer test, and validated questionnaires (Patient-Reported Outcomes with LASIK-Symptoms and Satisfaction; Standard Patient Evaluation of Eye Dryness). Flaps were created with the Zeiss VisuMax femtosecond laser, followed by TG or WFG excimer laser ablation. Outcomes were evaluated at multiple timepoints through 6 months.
Results: At 6 months, 54% of WFG-LASIK eyes and 46% of TG-LASIK eyes achieved UDVA of 20/16 or better ( P = .48). TG-LASIK showed a higher efficiency index (1.08 vs 1.02; P = .03) and better mean spherical equivalent (0.04 diopters [D] vs 0.13 D; P = .04), while WFG-LASIK had superior low-contrast UDVA and CDVA. Safety indices, residual HOAs, and dry eye symptoms were similar between groups. Both procedures significantly improved patient satisfaction and reduced visual disturbances compared with baseline.
Conclusions: Both…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 66 participants or records.
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