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Trial compares wavefront-optimized versus wavefront-guided sub-Bowman's keratomileusis


Las Vegas-Accurate refractive outcomes are achieved when sub-Bowman's keratomileusis (SBK) is performed with either a wavefront-optimized (WaveLight Technologie AG) or wavefront-guided (CustomCornea, Alcon Laboratories) ablation platform. The wavefront-guided procedure, however, appears to have a benefit for inducing less spherical aberration, according to analysis of 3-month results from a prospective contralateral-eye study reported by Dan Tran, MD, at the refractive surgery subspecialty day during the American Academy of Ophthalmology annual meeting here.

"Further investigation is needed, but our preliminary data suggest the benefit of the wavefront-guided procedure may be important in patients with larger pupils," said Dr. Tran, medical director, Coastal Vision Medical Group, Newport Beach, CA.

The single-surgeon study was designed to compare the objective and subjective visual outcomes using the different laser platforms. Dominant eyes of 19 patients were randomly assigned to one of the two procedures, and the alternate surgery was performed in the fellow eye.

HOAs were analyzed based on 6.0-mm dilated scans. Preoperatively mean HOA RMS was about 0.40 µm in both groups. At 3 months, mean HOA RMS was essentially unchanged after wavefront-guided treatment and increased slightly (about 0.1 µm) after wavefront-optimized treatment.

Good control of HOAs

"Due to the small sample size, differences from baseline were not statistically significant. In general, however, there was good control of HOA induction with both procedures," Dr. Tran said.

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