Objective: To assess efficacy,safety,predictability,stability,and changes in higher-order aberrations (HOAs) and contrast sensitivity (CS) after wavefront-guided and standard LASIK enhancement for the correction of residual refractive errors. Design: Prospective,randomized,comparative clinical study. Participants: Twenty eyes of 20 consecutive patients (spherical equivalent SE,-2.01± 1.36 diopters D) treated with wavefront-guided Zyoptix Ablation Refinement software (ZAR) LASIK and 20 eyes of 20 consecutive patients (SE,-1.81± 1.21D) treated with standard Planoscan LASIK,both for residual refractive error enhancement. Main Outcome Measures: Efficacy,safety,predictability,stability,HOAs,and CS were evaluated before and after enhancement at 6 months’ follow-up. Methods: Uncorrected visual acuity (UCVA),bestcorrected visual acuity (BCVA),manifest refraction,CS by means of the Functional Acuity Contrast Test,and HOAs by means of Zywave aberrometry were evaluated preoperatively and 6 months after retreatment. Results: At 6 months postoperatively,UCVA was 20/25 or better in 100% of the eyes. Efficacy indexes were 1.09 for ZAR patients and 0.95 for Planoscan patients. No eyes lost 0.01). Contrast sensitivity was reduced in the Planoscan group only at the highest spatial frequency (18 cycles per degree; P0.01). Conclusions: Wavefront-guided LASIK using the ZAR algorithm is an effective and safe procedure for treatment of residual refractive errors. Wavefront-guided LASIKdoes not increase HOAs and does not modify CS compared with preoperative values. Wavefront-guided LASIK seems to be better than standard LASIK for retreatments.
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