Higher-Order Aberrations of Topography-Guided LASIK and Wavefront-Optimized LASIK in High- and Low-Myopic Eyes: A Non-Randomized Controlled Trial

We aimed to investigate high-order aberration (HOA) change between topography-guided (TG) and wavefront-optimized (WFO) laser in situ keratomileusis (LASIK) in patients with different degrees of myopia. A non-randomized clinical trial was conducted, in which 40 eyes of 20 patients aged 20–50 years old were included. Participants received TG-LASIK in one eye and WFO-LASIK on the alternate eye. Corneal topography and HOAs including coma, trefoil, spherical aberration (SA), and contrast sensitivity (CS) were collected. Moreover, a quality of vision (QoV) questionnaire was completed by each participant. Non-parametric tests were used to infer the difference in HOAs and CS between the TG-LASIK and WFO-LASIK groups, and subgroup analyses stratified by myopia degree were performed. The high-myopia patients with TG-LASIK showed more coma and SA compared to low-myopia individuals (all 95% CI lower limits > 0), and subjects who received WFO-LASIK exhibited more SA in high-myopia status (both 95% CI lower limits > 0). The TG-LASIK group showed lower postoperative trefoil compared to the WFO-LASIK group in the high-myopia population (mean difference: −0.1267, 95% CI: −0.24 to −0.01). The TG-LASIK group yielded less surgically induced haze, better clarity at night, and better total quality scores (all p < 0.05). In conclusion, TG-LASIK might yield less postoperative trefoil in high-myopia patients and higher QoV in the general population compared to the WFO-LASIK procedure.