Wavefront analysis comparison of LASIK outcomes with the femtosecond laser and mechanical microkeratomes

PURPOSE: To evaluate differences related to ocular aberrations after customized LASIK for myopia using three-different microkeratomes. METHODS: Charts of 410 patients who underwent customized LASIK with the Alcon LADARVision4000 excimer laser were reviewed. Patients were stratified according to the device used to create the flap: Moria M2 microkeratome, Bausch & Lomb Hansatome microkeratome. or IntraLase laser. The difference between the wavefront pre- and postoperative value received a positive or a negative sign if the change occurred toward or away from zero, respectively, and it was compared to preoperative minus postoperative manifest refraction spherical equivalent (MRSE). RESULTS: Patients showed increase in the aberration level after LASIK with the three devices used in this study. IntraLase spherical aberration change tended to be better than mechanical microkeratomes for higher MRSE values (IntraLase compared to Hansatome. P≤.023 for MRSE values ≥4.00 diopters [D]; IntraLase compared to Moria, P≤.015 for MRSE values ≥2.00 D). For total aberrations, the improvement values for IntraLase tended to be higher than those for Moria (IntraLase compared to Moria, P≤.021 for MRSE values ≥3.00 D). For total higher order aberrations, IntraLase values tended to be better than Moria and Hansatome microkeratomes (IntraLase compared to Hansatome, P≤.047 for MRSE values between 3.00 and 8.00 D; IntraLase compared with Moria, P≤.002 for MRSE values ≥2.00 D). Change in coma root-mean-square was similar for the three groups. CONCLUSIONS: The findings suggest the femtosecond laser provides a better platform for LASIK than the commonly used microkeratomes analyzed in this study.