Comparison of Custom Ablation and Conventional Laser In Situ Keratomileusis for Myopia and Myopic Astigmatism Using the Alcon Excimer Laser

Purpose: To compare the refractive outcomes, higher order aberrations, and contrast sensitivity after laser in situ keratomileusis (LASIK) using wavefront ablation and conventional ablation. Setting: Private practice in Cordoba, Spain and a free-standing outpatient surgery center. Methods: This was a prospective, nonrandomized, observational case series comparing outcomes of 239 eyes that underwent LASIK for myopia and myopic astigmatism with either wavefront or conventional ablation using the LADARVISION excimer laser. Manifest refractive sphere ranged from 0.50 D to -8.00 D with astigmatism up to -4.00 D. Eighty-nine eyes underwent conventional LASIK (conventional group), and 150 eyes underwent custom ablation (custom group). Refractive outcomes, ocular higher order root mean square (HOA-RMS), and contrast sensitivity were tested for statistically significant differences between groups. A P-value less than 0.05 was considered statistically significant. Six month postoperative data are reported here. Results: Postoperatively, the mean SE was -0.03 D +/- 0.19 D for the custom group, and -0.14 +/- 0.35 D for the conventional group (P = 0.003). Ninety-nine percent of the eyes in the custom group, and 92% of the eyes in the conventional group were within 0.50 D of the intended correction (P > 0.05). The HOA-RMS was 0.16 mu m lower in the custom group (P < 0.001). Contrast sensitivity was statistically significantly better at 3 cycles per degree (cpd) (P < 0.001) and 6 cpd (P = 0.009) in the custom group. Conclusion: There was a statistically significant lower induction of HOA-RMS and better predictability and contrast sensitivity in eyes that underwent custom ablation with the LADARVISION excimer laser.