Corneal wavefront-guided enhancement for high levels of corneal coma aberration after laser in situ keratomileusis

Purpose To evaluate the improvement in visual and optical performance after corneal wavefront–guided laser in situ keratomileusis (LASIK) enhancement in patients with high levels of corneal coma aberration and complaints about quality of vision. Setting Vissum-Instituto Oftalmologico de Alicante, Alicante, Spain. Methods Corneal wavefront–guided LASIK enhancement was performed in 34 symptomatic eyes of 29 patients aged 26 to 64 years with previous LASIK surgery and a significant level of primary coma aberration. The ablation design was calculated using ORK-CAM software (Schwind eye-tech-solutions). The follow-up period was 6 months. Changes in refraction, corneal aberrometry, and subjective symptoms were analyzed. Results At 6 months, the mean efficacy index was 0.88 ± 0.12 and the mean safety index, 1.03 ± 0.16. The reduction in sphere and cylinder at 1 month was statistically significant ( P P = .01), and primary coma root mean square reduction ( P P Conclusion Corneal wavefront–guided enhancements with the ORK-CAM system are a useful tool for the correction of the second order refractive errors and for the reduction of the corneal primary coma induced by previous keratorefractive procedures.