Wavefront Optimized Versus Custom-Q Treatments in Surface Ablation for Myopic Astigmatism With the WaveLight ALLEGRETTO Laser

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Abstract
Purpose: To compare treatments with wavefront optimized and custom-Q ablations. Methods: Two consecutive groups of eyes were treated for myopia and astigmatism with surface ablation. One group was treated with wavefront optimized ablation and the second group was treated with custom-Q ablation. Preoperative and 3-month postoperative Q-values, higher order aberrations, low contrast visual acuity, and classic outcome parameters were analyzed. Results: The wavefront optimized ablation group was comprised of 46 eyes of 23 patients with a mean spherical equivalent refraction (SE) of −3.64 diopters (D) (range: −1.15 to −8.25 D); mean Q-value changed from −0.33 preoperatively to 0.06 postoperatively. The custom-Q ablation group was comprised of 42 eyes of 21 patients with a mean SE of −3.24 D (range: −1.47 to −8.00 D); mean Q-value changed from −0.36 preoperatively to −0.03 postoperatively. A statistically significant difference in postoperative change in Q-values ( P =.049) between the two groups was noted, but there was no such difference in higher order aberrations, low contrast visual acuity, or classic outcome parameters. Conclusions: Custom-Q ablation resulted in a mean postoperative asphericity that was closer to preoperative compared to wavefront optimized ablation, whereas the other outcome parameters showed no statistically significant differences. [ J Refract Surg. 2008;24:779–789.]

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