Alcon CustomCornea wavefront-guided retreatments after laser in situ keratomileusis

PURPOSE: To evaluate the outcome of wavefront-guided ablations for the correction of residual myopia and astigmatism after standard laser in situ keratomileusis (LASIK). METHODS: Twenty nine eyes of 26 patients who underwent wavefront-guided LASIK retreatment with Alcon CustomCornea (Alcon Laboratories Inc, Fort Worth, Tex) were evaluated. Complete ophthalmologic examination, corneal topography, and wavefront measurements were performed. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and wavefront analysis were evaluated preoperatively, 1 week, 3 months, and 6 months after surgery. Wavefront measurements were assessed using the LADARWave device. Statistical analysis was performed using the McNemar test and percentages of success. RESULTS: One week postoperatively, UCVA was ≥20/40 in 100% of eyes (≥20/20 in 31%) and BSCVA was ≥20/40 in 100% (≥20/20 in 73%). Wavefront analysis showed a decrease in total aberrations, high order aberrations, defocus, coma, spherical aberration, and other terms of higher order aberrations at 1-week follow-up. Three months postoperatively, UCVA was ≥20/40 in 100% of eyes (≥20/20 in 38%) and BSCVA was ≥20/40 in 100% (≥20/20 in 81%). Six months postoperatively, UCVA was ≥20/40 in 100% of eyes (≥20/20 in 60%) and BSCVA was ≥20/40 in 100% (≥20/20 in 90%). Wavefront analysis showed decrease in total aberration, high order aberration, defocus, coma, and spherical aberration. CONCLUSION: Wavefront-guided LASIK retreatment in post-LASIK eyes represents a good option for laser vision correction. All eyes showed reduction in pre-existing total aberrations. Some high order aberration components decreased in this initial series. Further follow-up is necessary to assess the initial predictability of wavefront-guided LASIK upgrade.