Postoperative refractive surgery disturbances of 2 procedure types are similarly uncommon, according to an analysis of subjective patient experience published in the American Journal of Ophthalmology. In a study comparing subjective visual experiences and ocular symptoms of fellow eyes treated with wavefront-optimized (WFO) laser-assisted in situ keratomileusis (LASIK) and wavefront-guided (WGO) LASIK, most patients reported no preference, and those who did report a preference demonstrated better visual acuity in the preferred eye.
Researchers conducted a prospective, randomized, controlled study to compare the subjective experience with postoperative refractive surgery disturbances and ocular symptoms of patients treated with WFO LASIK in 1 eye and WFG LASIK in the other.
A total of 200 eyes of 100 patients (mean age, 33.51 years; range, 21-55) with myopia or compound myopic astigmatism being treated at a single academic center were randomly assigned to undergo WFO LASIK in 1 eye and WFG LASIK in the fellow eye. They completed a validated questionnaire to rate the visual experience and ocular symptoms for each eye at the preoperative visit and postoperative visits (1, 3, 6, and 12 months).
The researchers found no significant difference in the number of patients who reported any postoperative refractive surgery disturbances (glare, halos, starbursts, hazy vision, blurred vision, distortion, double or multiple images, fluctuations in vision, focusing difficulties, and depth perception; P >.05 for all) or ocular symptom (photosensitivity, dry eye, foreign body sensation, and ocular pain; P >.05 for all) for the WFG- vs WFO-LASIK eyes.
The study shows most patients (43%) had no preference for either procedure. Another 28% preferred the WFG-LASIK treated eye while 29% reported a preference for the WFO-LASIK treated eye (Chi-squared, P =.972).
Further assessment revealed that patients who preferred 1 eye instead of the other had significantly better vision in that preferred eye (0.8±1.4 Snellen line; P =.0002).
“As previously described, WFG-LASIK and WFO-LASIK resulted in excellent visual outcomes, with WFG-LASIK achieving better uncorrected visual acuity and contrast sensitivity,” the researchers report.
Limitations of the study included difficulty for the investigators to interpret survey responses and potential difficulty for patients to identify which eye was causing the postoperative refractive surgery disturbances or ocular symptoms.
Disclosure: This research was supported by Johnson and Johnson Vision. Multiple study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Chiang B, Manche EE. Subjective visual experience and ocular symptoms after wavefront-guided and wavefront-optimized LASIK in a prospective fellow eye study. Am J Ophthalmol. Published online March 2, 2023. doi:10.1016/j.ajo.2023.02.018