A Prospective Comparison of Wavefront-Guided LASIK versus Wavefront-Guided PRK After Previous Keratorefractive Surgery

PURPOSE: To compare the results of retreatment with wavefront-guided LASIK versus wavefront-guided PRK for residual refractive error following previous myopic keratorefractive surgery. METHODS: In this prospective study, 32 eyes of 28 patients after prior myopic keratorefractive surgery underwent retreatment with flap-lift wavefront-guided LASIK (n = 12) or wavefront-guided PRK (n = 20) for residual refractive error. Safety, efficacy, predictability, and wavefront outcomes were evaluated. RESULTS: At last follow-up, both LASIK and PRK retreatment resulted in similar improvement in visual acuity with respective mean ± standard deviation (SD) uncorrected distance visual acuity of -0.07 ± 0.11 logMAR and -0.06 ± 0.13 logMAR (p = 0.87). In the study, 16.7% of LASIK and 33.3% of PRK eyes gained one or more lines of best-corrected distance visual acuity (CDVA), while 16.7% and 9.5% of eyes lost one or more lines of CDVA with LASIK and PRK, respectively. One hundred % of LASIK eyes and 89.5% of PRK eyes were within ± 0.50 diopters of emmetropia. Wavefront analysis demonstrated similar reductions in total RMS error higher-order aberrations (p = 0.84) with no difference in coma, trefoil, or spherical aberration between eyes undergoing LASIK or PRK retreatment. CONCLUSION: Wavefront-guided LASIK and wavefront-guided PRK following previous keratorefractive surgery demonstrate similar safety, efficacy, and predictability with comparable wavefront outcomes.