Optimized femto-LASIK maintains preexisting spherical aberration independent of refractive error.

To report the visual outcomes and change in spherical aberration in the first cohort of eyes treated at the Cole Eye Institute using the FS200 laser (Alcon Laboratories Inc). A chart review was performed on 100 eyes targeted for emmetropia with wavefront-optimized femto-LASIK using the WaveLight Allegretto Wave Eye-Q (Alcon Laboratories Inc) and FS200 lasers. Patients were subdivided into low (< -3.00 D, n = 23), moderate (-3.00 to -6.00 D, n = 45), and high myopia (> -6.00 D, n = 2). Pre- and 3- to 9-month postoperative wavefront aberrometry and uncorrected distance visual acuity (UDVA) were compared. An increase was found in spherical aberration of 0.03 +/- 0.02 microm (P = .14) for low myopia, but decreases were found of 0.01 +/- 0.01 microm (P = .45) for moderate myopia and 0.02 +/- 0.04 microm (P = .48) for high myopia. An increase in coma was noted of 0.02 +/- 0.02 microm (P = .37), 0.04 +/- 0.02 microm (P = .02), and 0.11 +/- 0.04 microm (P = .01) for low, moderate, and high myopes, respectively. An increase was found in total higher order aberrations of 0.05 +/- 0.04 microm (P = .17), 0.04 +/- 0.01 microm (P = .01), and 0.11-0.03 microm (P = .01) for low, moderate, and high myopes, respectively. Uncorrected distance visual acuity of 20/15 and 20/20 was achieved in 70% and 91% of low myopes, 58% and 93% of moderate myopes, and 34% and 78% of high myopes, respectively. Wavefront-optimized femto-LASIK with the WaveLight Allegretto Wave Eye-Q and FS200 lasers achieved excellent postoperative UDVA outcomes, with no significant induction of spherical aberration at all refractive errors.