Purpose: To assess factors affecting changes in coma-like aberrations after myopic laser in situ keratomileusis (LASIK).
Methods: We retrospectively examined 91 eyes of 48 patients undergoing LASIK (mean patient age ± standard deviation, 29.6 ± 8.1 years; gender, 29 male and 19 female; manifest refraction, -4.76 ± 1.42 diopters). We quantitatively assessed the values of coma-like aberrations for 4-mm and 6-mm pupils using a Hartmann-Shack aberrometer before and 3 months after surgery. Multiple regression analysis was used to assess the relevant factors of the changes in coma-like aberrations.
Results: The mean changes in coma-like aberrations for 4-mm and 6-mm pupils were 0.08 ± 0.09 μm and 0.31 ± 0.30 μm, respectively. Explanatory variables relevant to the changes in coma-like aberrations were, in order of influence, amount of spherical equivalent correction (partial regression coefficient B = 0.022, p <0.001 for a 4-mm pupil, B = 0.090, p <0.001 for a 6-mm pupil), and surgical technique (B = -0.062, p = 0.01 for a 4-mm pupil, B = -0.169, p = 0.03 for a 6-mm pupil). No significant correlation was seen with other clinical factors such as age, gender, astigmatism correction, mean keratometric readings, central corneal thickness, or eye tracking (with or without).
Conclusions: High myopic eyes requiring larger amounts of laser correction and eyes undergoing conventional LASIK tend to induce more coma-like aberration after surgery. Wavefront-guided LASIK may be a better surgical approach for preventing the induction of coma-like aberrations, especially in eyes with high myopia.