Comparing corneal higher-order aberrations in corneal wavefront-guided transepithelial photorefractive keratectomy versus small-incision lenticule extraction

Hun Lee, David Sung Yong Kang, Dan Z. Reinstein, Samuel Arba-Mosquera, Eung Kweon Kim, Kyoung Yul Seo, Tae im Kim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: To evaluate the changes in corneal higher-order aberrations (HOAs) after corneal wavefront-guided transepithelial photorefractive keratectomy (PRK) and small-incision lenticule extraction (SMILE). Setting: Yonsei University College of Medicine and Eyereum Eye Clinic, South Korea. Design: Retrospective case series. Methods: Medical records of patients having either corneal wavefront-guided transepithelial PRK or small-incision lenticule extraction were examined. The root-mean-square total HOAs, 3rd-order coma aberration, and 4th-order spherical aberration were measured preoperatively and 6 months postoperatively. Independent t tests and analysis of covariance were used to compare changes in corneal HOAs between the 2 groups. Results: The study comprised 77 eyes having corneal wavefront-guided transepithelial PRK and 81 eyes having small-incision lenticule extraction. The total HOAs and spherical aberration increased after transepithelial PRK (all P <.001), whereas coma aberration was stable after transepithelial PRK. The total HOAs, spherical aberration, and coma aberration increased after small-incision lenticule extraction (P <.001 for total HOAs, spherical aberration; P =.004 for coma). At 6 months postoperatively, total HOAs and spherical aberration were significantly larger in the transepithelial PRK group than in the small-incision lenticule extraction group. Coma aberration was larger in the small-incision lenticule extraction group than in the transepithelial PRK group. Spherical aberration induction was significantly smaller in the small-incision lenticule extraction group than in the transepithelial PRK group (P <.001), and coma aberration induction was larger in the small-incision lenticule extraction group than in the transepithelial PRK group (P =.011). Conclusions: Small-incision lenticule extraction demonstrated that the induction of total HOAs was comparable to corneal wavefront-guided transepithelial PRK, accompanied by smaller spherical aberration induction and larger coma aberration induction. During small-incision lenticule extraction, surgeons should aim to obtain optimum centration for smaller induction of corneal HOAs.

Original languageEnglish
Pages (from-to)725-733
Number of pages9
JournalJournal of cataract and refractive surgery
Volume44
Issue number6
DOIs
Publication statusPublished - 2018 Jun

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology
  • Sensory Systems

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