Evaluation Of Visual Quality Of Wavefront-guided Aspherical Personalized LASIK For Myopia

PurposeLaser in situ keratomileusis is currently mainstream refractive surgery procedure for its good stability, safety, validity and predictability. Some patients still complained of postoperative glare, flare and other optical complications, This is because the traditional refractive operation can only be corrected with low order aberration of human eye, high order aberrations cannot be corrected。In order to effectively improve uncomfortable symptoms, LASIK operation appeared Personalized treatment mode,which are Wavefront-guided and Q-value guided aspheric LASIK, The former can effectively eliminate or reduce preoperative existing high order aberrations, but cannot avoid intraoperative induced aberration,The latter could reduce intraoperative induced aberration, maintain postoperative corneal asphericity, but can not be corrected preoperative existing high order aberrations, although postoperative visual quality after refractive operation has been greatly improved than the traditional refractive operation, but the elimination of high order aberration corneal refractive operation has its own limitations. Wavefront-guided aspherical personalized LASIK treatment mode On the wave as the basis can eliminate or reduce preoperative existing high order aberrations at the same time in the course of treatment does not introduce a new spherical aberration, reduction of postoperative patients of general high order aberration, could theoretically improve the patient’s quality of vision. The purpose of this study is assessment of visual quality of Wavefront-guided aspherical personalized LASIK treatment mode through observing the preoperative and postoperative visual acuity, refraction, Q value, wavefront aberration, contrast sensitivity and CS under the glare stimulus.Methods120patient with myopia and/or astigmatism(240eyes) were involved,and the patients had a period of6months after LASIK in our hospital from August2010to December2010. There were male63patients(126eyes), female57patients (114eyes). According to the principle of randomization were included in a prospective study, divided into three groups:Wavefront-guided aspherical personalized LASIK in group PTA; Wavefront-guided LASIK in group PT; Q-value guided aspheric LASIK in group AS. FEMTO LDV femtosecond laser system made corneal flap, Technolas217z100excimer laser was treated. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, Q value, wavefront aberration, contrast sensitivity and contrast sensitivity under the glare stimulus were evaluated preoperatively and1day,1week,1month,3months and6months after treatment.T test and Analysis of variance used to analysis using Statistical analysis software SPSS17.0, P<0.05was used as a standard test.Results1All the operation was successfully completed without any serious postoperative complications affecting the visual quality.2Visual acuity and Refraction:(1)Safety:Three groups were not influence the postoperative visual acuity of complications, there were not loss of BSCVA;(2)Efficacy:Postoperative UCVA had reached or exceeded preoperative BSCVA in three groups;(3)Stability:Postoperative MRSE value were ideal, In+/-0.50D from within all accounting for more than80%;(4)Predictability: Postoperative residual Refraction changed Smoothly all in+/-0.50D.3Q value:Postoperative Q value turns positive from negative in group PTA,the differences was statistically significant compared with preoperative Q value (Pall<0.05). the differences were statistically significant between PTA and PT in all postoperative period(Pall<0.05),and the differences were statistically significant in postoperative early period (1week and1month) and not statistically significant in postoperative late period(3months and6months).4High order aberration:The differences between before and after surgery were not statistically significant in higher order aberration and coma aberration and was statistically significant spherical aberration between before and1month,3months and6months after surgery in group PTA. At6months, The differences were statistically significant between PTA and PT (P<0.05) and not statistically significant between PTA and AS (P>0.05) in higher order aberration and spherical aberration.5CS and CS under the glare stimulus:Photopic and mesopic CS was not different before and after the surgery,and Glare didn’t influence the CS. In photopic conditions, the differences were statistically significant between PTA and PT at1.5and3.0cpd (P<0.05) and were not statistically significant between PTA and AS (P>0.05) at1week, the differences were not statistically significant (Pall>0.05) in all spatial frequencies among three groups at6months. In mesopic conditions, the differences were statistically significant between PTA and PT at1.5,3.0and6.0cpd (P<0.05) and not statistically significant at high spatial frequencies at1week. The differences were statistically significant between PTA and PT at1.5,3.0,12.0and18.0cpd and The differences were the same between PTA and AS at18.0cpd at6months(P<0.05).Conclusion1.Wavefront-guided aspherical personalized LASIK has good safety, efficacy, stability and predictability.2.Wavefront-guided aspherical personalized LASIK can effectively reduce the increases of the high order aberration and spherical aberration,keep the corneal aspherieity morphology,and get a good postoperative visual quality.