Title Visual Outcomes After Wavefront-guided Photorefractive Keratectomy and Wavefront-guided Laser in Situ Keratomileusis: Prospective Comparison.


Published October 2010 in the Journal of Cataract and Refractive Surgery


To compare visual outcomes between wavefront-guided photorefractive keratectomy (PRK) and wavefront-guided laser in situ keratomileusis (LASIK).


Academic center, Salt Lake City, Utah, USA.


In this randomized prospective study, myopic eyes were treated with wavefront-guided PRK and or wavefront-guided LASIK using a Visx Star S4 CustomVue platform with iris registration. Primary outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities and manifest refraction. Secondary outcome measures were higher-order aberrations (HOAs) and contrast sensitivity.


The PRK group comprised 101 eyes and the LASIK group, 102 eyes. At 6 months, the mean UDVA was −0.03 logMAR ± 0.10 [SD] (20/19) and 0.07 ± 0.09 logMAR (20/24), respectively (P = .544). In both groups, 75% eyes achieved a UDVA of 20/20 or better (P = .923); 77% of eyes in the PRK group and 88% in the LASIK group were within ±0.50 diopter of emmetropia (P = .760). There was no statistically significant difference between groups in contrast sensitivity at 3, 6, 12, or 18 cycles per degree. The mean postoperative HOA root mean square was 0.45 ± 0.13 μm in the PRK group and 0.59 ± 0.22 μm in the LASIK group (P = .012), representing an increase factor of 1.22 and 1.74, respectively.


Wavefront-guided PRK and wavefront-guided LASIK had similar efficacy, predictability, safety, and contrast sensitivity; however, wavefront-guided PRK induced statistically fewer HOAs than wavefront-guided LASIK at 6 months.

Financial Disclosure

No author has a financial or proprietary interest in any material or method mentioned. Supported in part by an unrestricted educational grant from Allergan, Inc., Irvine, California, to the Department of Ophthalmology and Visual Sciences, University of Utah, John A. Moran Eye Center, Salt Lake City, Utah, USA.