Refractive Surgery Outcomes Comparison—All Wavefront-guided Versus a Decision Tree for Selecting Wavefront-guided or Wavefront-optimized

The purpose of this article is to compare refractive outcomes based on all wavefront-guided procedures versus a decision tree designed to assist with the selection of wavefront-guided or wavefront-optimized procedures. The setting was the The Laser Center, Greensboro. Twenty subjects were treated with a VISX CustomVue™ wavefront-guided refractive procedure in one eye and a WaveLight Allegretto procedure (wavefront-guided or optimized) in the contralateral eye. A decision tree was used to decide whether a wavefront-guided or wavefront-optimized procedure would be performed with the WaveLight system. The CustomVue eye was chosen at random. Visual acuity and refractive error were recorded pre-operatively and post-operatively. Subjective post-operative data included patient reported eye preference and post-operative glare and halos. The results were that one subject was lost to follow-up, leaving 19 subjects for analysis at three months. Of those subjects with data, 12 received wavefront-optimized treatment while seven subjects received a wavefront-guided treatment with the WaveLight laser. There were no significant differences in uncorrected visual acuity between the VISX and Wavelight groups at the one-day or six-month visits. At three months, 56 % of patients indicated no preference, with the remaining 44 % indicating a preference for the WaveLight-treated eye (p<0.05). The patient reported outcomes showed a similar incidence of post-operative glare and halos reported between the two treatments. Results with the Allegretto Wave Eye-Q laser, using a decision tree to determine whether a wavefront-optimized or a wavefront-guided treatment would be performed, were equivalent to those achieved with the VISX Star S4 wavefront-guided procedure.