Higher order aberrations of Topography-guided LASIK and Wavefront Optimized LASIK in high and low myopic eyes: a non-randomized controlled trial

Background: To investigate high order aberration (HOA) change between topography-guided (TG) and wavefront-optimized (WFO) laser is situ keratomileusis (LASIK) in high myopia Asian. Methods: : A non-randomized clinical trial was conducted in an ophthalmic clinic in northern Taiwan. 40 eyes of 20 patients aged 20-50 years old were included. Participants received TG-LASIK in one eye and WFO-LASIK on alternate eye. Corneal topography, HOAs including coma, trefoil, spherical aberration (SA), and contrast sensitivity (CS) were collected. Besides, quality of vision (QoV) questionnaire was done by each participant. Nonparametric test were used to infer difference of HOAs and CS between TG-LASIK and WFO-LASIK groups, and subgroup analyses stratified by myopia degree were done. Meta-analysis of our data with 4 previous studies contained 460 eyes was done for HOAs. Results: : Postoperative SA and coma in both groups significantly increased (all P <0.05). A marginally lower postoperative trefoil after TG-LASIK was found in high myopia subgroup (mean difference: -0.1267, 95% confidence interval (CI): -0.25 to -0.01). The high myopia patients showed more coma and SA compared to low myopia individuals if received TG-LASIK (all 95% CI lower limits>0), and subjects received WFO-LASIK revealed more SA in high myopic status (both 95% CI lower limits>0). Besides, the TG-LASIK group yielded less surgery-induced haze, better clarity at night, and better total quality scores (all P <0.05). In meta-analysis, TG-LASIK has significant superioriy over WFO-LASIK for coma. Conclusions: Increment of coma and SA are more prominent in high myopia patients receiving TG-LASIK, while both procedures yielded significant postoperative coma and SA. Trial registration: We registered this study on ClinicalTrials.gov (identifier NCT04919291).