Purpose: To report refractive and visual acuity outcomes using wavefront-guided optical path difference custom ablation treatments (OPDCAT; NIDEK Co Ltd) for myopia and myopic astigmatism.
Methods: One hundred eyes of 50 patients with preoperative manifest refraction spherical equivalent (MRSE) of 4.62+/-1.30 diopters (D) (range: -1.38 to -7.25 D) with mean astigmatism of -0.57+/-0.37 D (range: 0 to -1.75 D) underwent LASIK with OPDCAT. Eyes that had > or =5 microm of irregularity preoperatively underwent additional irregularity treatment (irregularity group) and were compared with eyes that did not undergo irregularity ablation (aspheric group). An independent-samples t test was used to analyze refractive outcomes at 3 months postoperatively. A P value <.05 was considered statistically significant.
Results: The mean postoperative MRSE was 0.18+/-0.35 D (range: -0.63 to 1.00 D). Ninety-six (96%) eyes had uncorrected visual acuity of 20/20 or better and 87 (87%) eyes were within +/-0.50 D of the intended correction. No eyes lost two or more lines of best spectacle-corrected visual acuity (BSCVA), 1 (1%) eye lost one line of BSCVA, and 99 (99%) eyes maintained gained lines of BSCVA. The MRSE changed 0.02 D between 1 and 3 months postoperatively. A statistically significant increase was noted in higher order aberrations in the entire cohort (P<.05) with lower induced higher order aberration and coma aberrations in the irregularity group (P<.05).
Conclusions: LASIK using wavefront-guided OPDCAT ablation with or without irregularity is safe and efficacious for the treatment of myopia with astigmatism. The irregularity treatment induces fewer higher order aberrations than aspheric ablation.