Comparison of visual quality after wavefront-guided LASIK in patients with different levels of preoperative total ocular higher-order aberrations: a retrospective study

Purpose: To compare the visual quality after wavefront-guided femtosecond LASIK (WFG FS-LASIK) in patients with different levels of preoperative total ocular higher-order aberrations to guide clinical decision-making regarding patient selection and treatment strategies. Methods: This study included 112 right eyes of 112 patients who previously underwent WFG FS-LASIK for correcting myopia and myopic astigmatism. The patients were divided into two groups based on the mean values of preoperative total ocular HOAs (0.30 +/- 0.09 mu m): HOA <= 0.3 and > 0.3 groups. The visual acuity, manifest refraction, corneal Strehl ratio (SR), root mean square (RMS) of corneal and ocular aberrations, and area under the log contrast sensitivity function (AULCSF) of both groups were compared preoperatively and at 1, 3, 6, and 12 months postoperatively. Results: The induced ocular HOAs and coma (A = 1 mo - Preop) were significantly fi cantly lower in the HOAs > 0.3 group than in the HOAs <= 0.3 group (AHOAs: 0.39 +/- 0.19 vs. 0.29 +/- 0.18 m m, t = 2.797, P = 0.006; A coma: 0.30 +/- 0.19 vs. 0.20 +/- 0.21 m m, t = 2.542, P = 0.012). In the HOAs > 0.3 group, AHOAs were negatively correlated with the preoperative ocular HOAs (r = - 0.315, P = 0.019). In the HOAs <= 0.3 group, the regression equation for A HOAs = 0.098 + 0.053 SE (F = 21.756, P < 0.001). In the HOAs > 0.3 group, the regression equation for AHOAs = 0.534 - 1.081 HOAs + 0.038 Sphere (F = 7.954, P = 0.001). The postoperative uncorrected distance visual acuity, spherical equivalent, corneal aberrations, SR and AULCSF of both groups were similar (all P > 0.05). Furthermore, the ocular aberrations were not significantly fi cantly different between both groups at 3, 6, and 12 months postoperatively (all P > 0.05). In addition, compared with the preoperative period, the AULCSF of both groups were significantly fi cantly increased in the postoperative period (all P < 0.05). Conclusions: The induced ocular HOAs and coma in HOAs > 0.3 group were lower. However, both groups achieved equivalent and excellent visual quality after WFG FSLASIK. WFG FS-LASIK may provide significant fi cant visual benefits fi ts for a wider range of patients.