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Comparison of visual acuity, higher-order aberrations and corneal asphericity after refractive lenticule extraction and wavefront-guided laser-assisted in situ keratomileusis for myopia
  1. Kazutaka Kamiya1,
  2. Kimiya Shimizu1,
  3. Akihito Igarashi1,
  4. Hidenaga Kobashi1,
  5. Mari Komatsu2
  1. 1Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
  2. 2Department of Ophthalmology, Sanno Hospital, Tokyo, Japan
  1. Correspondence to Dr Kazutaka Kamiya, Department of Ophthalmology, University of Kitasato School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0374, Japan; kamiyak-tky{at}umin.ac.jp

Abstract

Aim To compare postoperative visual acuity, higher-order aberrations (HOAs) and corneal asphericity after femtosecond lenticule extraction (FLEx) and after wavefront-guided laser-assisted in situ keratomileusis (wfg-LASIK) in myopic eyes.

Methods We examined 43 eyes of 23 patients undergoing FLEx and 34 eyes of 19 patients undergoing wfg-LASIK to correct myopia. Ocular HOAs were measured by Hartmann-Shack aberrometry and corneal asphericity was measured by a rotating Scheimpflug imaging system before and 3 months after surgery.

Results There was no statistically significant difference in uncorrected (p=0.66 Mann–Whitney U-test) or corrected distance visual acuity (p=0.14) after two surgical procedures. For a 6-mm pupil, the changes in fourth-order aberrations after FLEx were statistically significantly less than those after wfg-LASIK (p<0.001). On the other hand, there were no statistically significant differences in the changes in third-order aberrations (p=0.24) and total HOAs (p=0.13). Similar results were obtained for a 4-mm pupil. The positive changes in the Q value after FLEx were statistically significantly less than those after wfg-LASIK (p=0.001).

Conclusions In myopic eyes, FLEx induces significantly fewer ocular fourth-order aberrations than wfg-LASIK, possibly because it causes less oblation in the corneal shape, but there was no statistically significant difference in visual acuity or in the induction of third-order aberrations and total HOAs. It is suggested that FLEx is essentially equivalent to wfg-LASIK in terms of visual acuity and total HOA induction, although the characteristics of HOA induction are different.

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