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2 S ince the advent of the femtosecond laser, refrac- tive surgery has been divided into wavefront- guided (WFG) and wave- front-optimized (WFO) platforms. Both platforms have superior safety profiles with similar results in num- ber of lines gained or lost. WFG LASIK is based on aberrometry measurements and treats both re- fractive errors and higher-order aberrations. WFO LASIK treats the spherocylinder error but does not affect the higher-order aberrations. We conducted a prospective, con- tralateral study on 110 eyes (55 pa- tients), where each eye was random- ized to either WFG or WFO LASIK. Background In the contralateral study, we ran- domized each eye according to ocu- lar dominance to either a WFG or WFO procedure. We used the VISX Star S4 IR CustomVue excimer laser (Abbott Medical Optics, AMO, Santa Ana, Calif.) for all the WFG LASIK procedures and the Allegretto Wave Eye-Q 400-Hz excimer laser (Alcon, Fort Worth, Texas) for all the WFO LASIK procedures. All of the LASIK flaps were created with the IntraLase iFS femtosecond laser (AMO). The average age of the patients was 37 years (with a range of 24-55 years); 53% of the patients were female. Higher- and lower-order aberrations were similar between the groups. Results Pre-op, there were no statistical differences between the two groups. Manifest sphere (±SD) was –5.22 (±2.38) in the WFG group and –5.26 (±2.07) in the WFO group. Manifest cylinder was +0.94 (±0.86) in the WFG group and +0.91 (±0.91) in the WFO group. At 6 months post-op, manifest sphere was –0.22 (±0.42) in the WFG group and –0.44 (±0.38) in the WFO group. By 12 months post- op, manifest sphere had remained essentially the same at –0.28 (±0.46) in the WFG group and decreased slightly to –0.56 (±0.41) in the WFO group. Manifest cylinder was +0.94 (±0.86) in the WFG eye pre-op and +0.91 (±0.91) in the WFO eye. By 12 months, manifest cylinder was +0.29 (±0.30) in the WFG eye and +0.30 (±0.30) in the WFO eye. Predictability was similar between the two groups at 12 months, with 87.3% within 0.5 D of target and 98.2% within 1.0 D in the WFG eye. In the WFO eye, 78.1% were within 0.5 D and 98.2% were within 1.0 D. The differences in uncorrected visual acuity were statistically significant and held through month 12. By 12 months almost 50% of the WFG eyes had gained one line of BCVA, compared to 37% in the WFO group. By 12 months, HOAs were higher in the WFO eyes compared to the WFG eyes, with the exception of spherical aberration, which was the same in both groups. These differences were not statistically significant. Patient satisfaction was higher in the WFG eyes than the WFO eyes; these differences continued to increase at 3 months, 6 months, and 12 months. Dr. Manche is professor of ophthalmology and director of the Cornea and Refractive Surgery Division at Stanford School of Medicine, Calif. He can be reached at edward.manche@stanford.edu. EW Chicago 2012 2 Laser vision correction by Edward E. Manche, M.D. WF-guided vs. WF-optimized: A prospective, randomized comparison Edward E. Manche, M.D. " By 12 months almost 50% of the WFG eyes had gained one line of BCVA, compared to 37% in the WFO group " Figure 1: One-day post-op uncorrected visual acuity Figure 2: At 12 months, more eyes in the WF-guided group reached visual acuity levels of 20/20 or better than eyes in the WF-optimized group. These differences were statistically significant AMO Saturday supplement_Chicago 2012-USE THIS ONE_Layout 1 4/20/12 4:25 PM Page 2

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