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Purpose: To compare higher-order aberrations (HOAs) and visual acuity after wavefront-guided and wavefront-optimized laser keratorefractive surgery. Methods: This retrospective study consisted of consecutive cases of eyes that underwent wavefront-guided (VISX S4 CustomVue®) or wavefront-optimized (WaveLight® EX500) laser assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), and preoperative and 3 month postoperative HOAs were compared. Results: There were no statistical differences in UCVA, BCVA, MRSE, or total HOAs in either the LASIK and PRK groups (all p > 0.05). Induced amount of spherical aberration (SA) was significantly lower in the wavefront-optimized LASIK and PRK than wavefront-guided LASIK and PRK. Conclusions: In laser keratorefractive surgery, wavefront-guided and wavefront-optimized platforms produced equivalent visual outcomes and no differences in total HOAs. However, the wavefront-optimized platform caused less spherical aberration 3 months after operation. J Korean Ophthalmol Soc 2014;55(4):480-485

Higher-Order Aberrations and Visual Acuity with Wavefront-Guided and Wavefront-Optimized Ablation in Laser Keratorefractive Surgery