Comparative study of higher-order aberrations after conventional laser in situ keratomileusis and laser epithelial keratomileusis for myopia using the technolas 217z laser platform.

Purpose To examine changes in higher-order aberrations (HOAs) after PlanoScan laser in situ keratomileusis and (LASIK) and laser epithelial keratomileusis (LASEK). Design Prospective, comparative study. Methods Myopic patients undergoing LASIK (65 eyes of 36 patients) and LASEK (50 eyes of 28 patients) at a private practice were selected randomly. Surgery was performed using the Technolas 217z laser (Bausch & Lomb, Surrey, United Kingdom). Main outcome measures included uncorrected visual acuity (UCVA), manifest refractive spherical equivalent (MRSE), and aberrometry (Zywave; Bausch & Lomb, Rochester, New York, USA) and were recorded before surgery and at three and 12 months after surgery. Results There was no statistical difference between both groups in terms of MRSE ( P = .91), ablation depth ( P = .47), scotopic pupil size ( P = .38), or optical zone ( P = .07). Before surgery, there was no statistical difference in root mean square (RMS) of total ( P = .70), third- ( P = .79), fourth- ( P = .23), and fifth- ( P = .33) order aberrations and individual terms. Three months after surgery, RMS of total HOA was raised significantly more ( P = .03) after LASIK (1.46-factor increase) than LASEK (1.25-factor increase). One year after surgery, a reduction in total HOAs was observed in 13.8% of LASIK- and 48.5% of LASEK-treated eyes compared with preoperative levels. Conclusions Postoperative increases in total HOA and vertical coma were significantly greater in LASIK- than in LASEK-treated eyes. Postoperative reduction in total HOAs was observed in a number of eyes with high preoperative levels and occurred more frequently in LASEK-treated eyes.