Comparison of the 1st Generation and 3rd Generation Wavefront-Guided LASIK for the Treatment of Myopia and Myopic Astigmatism

Stephen J Hannan; David Teenan; Jan A Venter; Keith A Hettinger; Colin W Berry; Noelle C Hannan; Huba J Kiss; Dasi Raju; Julie M Schallhorn

doi:10.2147/OPTH.S434037

Comparison of the 1st Generation and 3rd Generation Wavefront-Guided LASIK for the Treatment of Myopia and Myopic Astigmatism

Clin Ophthalmol. 2023 Nov 22:17:3579-3590. doi: 10.2147/OPTH.S434037. eCollection 2023.

Authors

Stephen J Hannan¹, David Teenan¹, Jan A Venter¹, Keith A Hettinger¹, Colin W Berry¹, Noelle C Hannan¹, Huba J Kiss¹, Dasi Raju¹, Julie M Schallhorn^{2

3}

Affiliations

¹ Optical Express, Glasgow, United Kingdom.
² University of California, San Francisco, Department of Ophthalmology, San Francisco, CA, USA.
³ F.I. Proctor Foundation, University of California, San Francisco, San Francisco, CA, USA.

Abstract

Purpose: To compare refractive, visual, and patient-reported outcomes associated with a 1st generation wavefront-guided (WFG) treatment with those associated with a 3rd generation WFG treatment.

Patients and methods: This retrospective study included patients who underwent femtosecond laser-assisted in situ keratomileusis (LASIK) for myopia/myopic astigmatism. Two random stratified samples of patients who underwent either 1stgeneration (WaveScan, Johnson & Johnson Vision, Santa Ana, CA) or 3rd generation (iDesign 2.0, Johnson & Johnson Vision, Santa Ana, CA) treatment matched on preoperative refraction were compared (4290 eyes of 2145 patients in each group). One-month postoperative visual, refractive, and patient-reported outcomes were analyzed. Refractive and monocular visual acuity analyses were performed using one random eye of each patient.

Results: The percentage of eyes achieving 20/20 or better uncorrected vision was 91.3% (1958/2145) in the 1st generation group and 95.9% (2056/2145) in the 3rd generation group (p<0.01). Binocularly, the percentage of patients with 20/20 or better UDVA was 97.0% (2080/2145) and 99.2% (2127/2145) in the 1st and 3rd generation groups, respectively (p<0.01). The mean postoperative MSE was -0.01 ± 0.33 D in the 1st generation group and +0.19 ± 0.33 D in the 3rd generation group (p<0.01). Postoperative refractive astigmatism had a mean value of -0.20 ± 0.26 D and -0.18 ± 0.24 D in the 1st and 3rd generation groups, respectively (p<0.01). The mean correction index of refractive astigmatism was 1.09 ± 0.53 in the 1st generation group and 1.02 ± 0.38 in the 3rd generation group, p<0.01. The overall percentage of patients satisfied with vision was 92.8% (1991/2145 patients) in the 1st generation group and 97.3% (2087/2145 patients) in the 3rd generation group (p<0.01).

Conclusion: For the majority of postoperative variables, there were significant differences between 1st and 3rd generation treatments. The 3rd generation treatments had better visual acuity outcomes and higher patient satisfaction.

Keywords: aberrometer; myopia; patient-reported outcomes; refractive outcomes; wavefront-guided LASIK.