Visual Quality Comparison Of Corneal Topography Guided FS-LASIK And Wavefront Optimized FS-LASIK For Asymmetric Astigmatism Correction

Objective:To compare the visual quality following topography guided Femtosecond laser in situ Keratomileusis(FS-LASIK)versus wavefront optimized FS-LASIK for astigmatism of asymmetrical myopia.Methods: In this prospective randomized cohort trial,128 eyes from 64 patients undergoing corneal topography guided FS-LASIK and wavefront optimized FS-LASIK for asymmetric astigmatism correction in our hospital were enrolled.The patients were allocated either to the TG or the WO group(64 eyes in each group)based on complete randomization.The following parameters were evaluated preoperatively and at 3 months’ postoperative visit:uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),spherical equivalent(SE),root-mean-square of higher order aberrations(RMSH),spherical aberration(C12),coma,modulation transfer function cutoff(MTF cutoff)frequency and objective scatter index(OSI).Results:(1)At 3 months’ postoperative visit,93.3% and 90% eyes in TG and WO groups,respectively,demonstrated a UCVA of 1.0or better,and 80% and 66.7% eyes had UCVA of 1.2 or better,13% and 7% eyes had UCVA of 2 or more than that in preoperative BCVA.A spherical equivalent within 0.5D was achieved in 97% and 74% of the eyes in the TG and WO groups,respectively(X2=4.63,P=0.03).(2)At 3 months postoperatively,cylinder power were statistically different between the TG group(-0.12±0.32D)and the WO group(-0.34±0.29D)(t=2.855,P=0.006).There was significant difference in the safety indices between the TG group(1.32±0.14)and the WO group(1.24±0.12)(t=2.376,P=0.010).Coma were significantly different between the TG group(0.14±0.12)and the WO group(0.22±0.13)(t=2.477,P=0.008).MTF cutoff were higher with the TG group(44.43±8.09)as compared to the WO group(40.13±11.02)(t=1.722,P=0.045).Conclusions:1.Both corneal topography guided FS-LASIK and wavefront optimized FS-LASIK procedures provide good safety and predictability in asymmetric astigmatism correction,and patients can obtain favorable optical and visual quality postoperatively.2.Corneal topographic map guidance is more predictive than wavefront optimized FS-LASIK for correction of astigmatism,less coma is introduced in the treatment of asymmetric corneal astigmatism,and visual quality is better after operation.