Comparative Analysis of Corneal Higher-Order Aberrations after Laser-Assisted In Situ Keratomileusis, Photorefractive Keratectomy, and Small Incision Lenticule Extraction with Correlations to Change in Myopic Q-Value and Spherical Equivalent with and without Astigmatism

Abstract

Background: This retrospective chart review compared the higher-order aberrations (HOAs) among photorefractive keratectomy (PRK), laser-assisted in situ keratomileusis (LASIK), and small incision lenticule extraction (SMILE) alongside changes in spherical equivalent (SEQ) and corneal shape (Q-value). Methods: Analyzing 371 myopic eyes, including 154 LASIK, 173 PRK, and 44 SMILE cases, Pentacam imaging was utilized pre-operatively and at one-year post-operative visits. Results: All procedures resulted in 100% of patients achieving an uncorrected distance visual acuity (UDVA) of 20/40 or better, with 87% of LASIK and PRK, and 91% of SMILE patients having 20/20 or better. Significant increases in HOAs were observed across all procedures (p < 0.05), correlating positively with SEQ and Q-value changes (LASIK (0.686, p < 0.05), followed by PRK (0.4503, p < 0.05), and SMILE (0.386, p < 0.05)). Vertical coma and spherical aberration (SA) were the primary factors for heightened aberration magnitude among the procedures (p < 0.05), with the largest contribution in SMILE, which is likely attributed to the centration at the corneal apex. Notably, PRK showed insignificant changes in vertical coma (−0.197 µm ± 0.0168 to −0.192 µm ± 0.0198, p = 0.78), with an increase in oblique trefoil (p < 0.05). Conclusions: These findings underscore differences in HOAs among PRK, LASIK, and SMILE, helping to guide clinicians.

Description

© 2024 by the authors. cc-by

Keywords

asphericity, astigmatism, cornea, higher-order aberrations, horizontal coma, LASIK, myopia, PRK, Q-value, refractive surgery, SMILE, spherical aberrations, spherical equivalent, trefoil, vertical coma

Citation

Moshirfar, M., Omidvarnia, S., Christensen, M.T., Porter, K.B., Theis, J.S., Olson, N.M., Stoakes, I.M., Payne, C.J., & Hoopes, P.C.. 2024. Comparative Analysis of Corneal Higher-Order Aberrations after Laser-Assisted In Situ Keratomileusis, Photorefractive Keratectomy, and Small Incision Lenticule Extraction with Correlations to Change in Myopic Q-Value and Spherical Equivalent with and without Astigmatism. Journal of Clinical Medicine, 13(7). https://doi.org/10.3390/jcm13071906

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