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J Cataract Refract Surg. 2018 Jun;44(6):725-733. doi: 10.1016/j.jcrs.2018.03.028. Epub 2018 May 19.

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

Author information

1
From the Department of Ophthalmology (Lee), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, the Institute of Vision Research (Lee, E.W. Kim, Seo, T-i Kim), Department of Ophthalmology and Corneal Dystrophy Research Institute (Kim), Yonsei University College of Medicine, the Eyereum Eye Clinic (Kang), Seoul, South Korea; London Vision Clinic (Reinstein), London, United Kingdom; Department of Ophthalmology (Reinstein), Columbia University Medical Center, New York, New York, USA; Centre Hospitalier (Reinstein), National d'Ophtalmologie, Paris, France; Schwind eye-tech-solutions GmbH and Co. KG (Arba-Mosquera), Kleinostheim, Germany.
2
From the Department of Ophthalmology (Lee), International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, the Institute of Vision Research (Lee, E.W. Kim, Seo, T-i Kim), Department of Ophthalmology and Corneal Dystrophy Research Institute (Kim), Yonsei University College of Medicine, the Eyereum Eye Clinic (Kang), Seoul, South Korea; London Vision Clinic (Reinstein), London, United Kingdom; Department of Ophthalmology (Reinstein), Columbia University Medical Center, New York, New York, USA; Centre Hospitalier (Reinstein), National d'Ophtalmologie, Paris, France; Schwind eye-tech-solutions GmbH and Co. KG (Arba-Mosquera), Kleinostheim, Germany. Electronic address: tikim@yuhs.ac.

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.

PMID:
29789156
DOI:
10.1016/j.jcrs.2018.03.028

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