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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Objective The aim was to compare the efficacy, safety, and predictability of corneal wavefront-guided (WFG) and aberration-free ablation in single-step transepithelial photorefractive keratectomy (TransPRK) in patients with myopia with high pre-existing corneal higher order aberrations (HOAs). Background Corneal WFG and aberration-free treatments have been proposed as methods to achieve better visual, refractive, and optical outcomes. Patients and methods A prospective case series was conducted in El-Hekma Eye-LASIK Center, Menoufia Governorate, Egypt, during the period from January 2017 to December 2017. TransPRK was performed for eligible patients with myopia with or without astigmatism with corneal HOAs greater than or equal to 0.35 μm using either aberration-free or corneal WFG patterns provided by ORK-CAM software. Uncorrected distance visual acuity, manifest and cycloplegic refractions, best spectacle corrected distance visual acuity, thorough slit lamp examination, and corneal topography were assessed and repeated 6 months postoperatively. Results Six months postoperatively, 97.6 and 100% of patients achieved manifest refraction spherical equivalent within ±1 D and 76.2 and 66.67% of patients achieved uncorrected distance visual acuity of greater than or equal to 20/20 in aberration-free and corneal WFG groups, respectively. Both groups showed increase in spherical and total corneal HOAs, with no significant difference in corneal WFG (P = 0.08 and 0.28, respectively), though significantly higher postoperatively in aberration-free group (P < 0.001 and 0.001, respectively). Coma and trefoil aberrations decreased after corneal WFG technique, yet increased after aberration-free one. Conclusion Both aberration-free and corneal WFG TransPRK were safe, effective, and predictable in treatment of myopia in patients with high pre-existing corneal HOAs with better aberrometric outcomes in corneal WFG group.

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