Wavefront-optimnized treatment provides most patients with excellent results, surgeon says

Dr. Stonecipher reported the results of the WaveLight FDA study that included 334 eyes that were followed for 3 months after treatment for myopia. Data collection was done by the clinical monitor Guy M. Kezirian, MD, FACS.

The study began in September 2004. One group of patients underwent wavefront-optimized treatment based on a phoropter or manifest refraction, and a second group underwent wavefront-guided treatments based on aberrometry. The patients had myopia that ranged up to 7.0 D and astigmatism up to 3.0 D.

"We obtained 20/20 or better visual acuity in both the wavefront-guided treatment group and the wavefront-optimized group at the 3-month examination with 95% and 94% reaching that target, respectively. The mean uncorrected visual acuity (UCVA) was 20/16 in 70% of the patients that underwent a wavefront-optimized treatment and in the group that underwent wavefront-guided treatment 62% of the patients reached that level of vision," he reported.

The postoperative mean spherical equivalent favored the wavefront-optimized treatment group, which may have resulted from a nomogram adjustment over the previous studies. The preoperative and postoperative evaluations of the best spectacle-corrected visual acuity (BSCVA) versus the UCVA were high at 83% in the wavefront-optimized group and 82% in the wavefront-guided group. There was no loss of BSCVA in either group.

Importance of RMSH

Dr. Stonecipher continued to emphasize the importance of the RMSH distribution; 81% of the eyes had an RMSH factor of less than 0.3 μm and in 96% of the eyes the RMSH was less than 0.4 μm. "When this is evaluated, the significance for the wavefront-guided group improved as the higher levels of root mean square were reached. However, the majority of the patients in both groups presented with a RMSH that did well with the wavefront-optimized profile," he explained.

"From this study it appears that only 5% to 10% of eyes may need a wavefront-guided treatment," he said.

"Excellent refractive predictability and visual outcomes can be obtained using wavefront-guided and wavefront-optimized treatments. In the absence of preoperative aberrations, results are similar for both treatments, but eyes with significant preoperative aberrations, such as coma and spherical aberration, may benefit from wavefront-guided treatments.