PURPOSE: To determine the level of success of wavefront-guided repair of night vision disturbances after conventional (Munnerlyn) myopic LASIK using a new parameter to describe higher order aberrations, and to compare the improvements to matched myopic LASIK controls who were symptom-free. METHODS: We developed a single parameter metric to represent raw spherical aberration (RAWS) to functionally describe the cumulative spherical aberration for an eye over a range of physiological pupil sizes. To derive the RAWS parameter, spherical aberration is plotted over pupil analysis zones from 3000 to 6000 µm. The RAWS parameter (unit = µm p 2 ) is then equal to the area under the plot. Sixteen eyes treated for night vision disturbances by wavefront-guided repair were each compared to the mean of four matched control eyes (total 64 eyes) treated by aspheric myopic ablation and without night vision disturbances. Contrast sensitivity and RAWs parameter for spherical aberration were determined for each of the repair eyes and control eyes before and after surgery. RESULTS: Following wavefront-guided repair, 76% of eyes were subjectively reported to have night vision disturbances improved by at least 80%. The percentage of eyes within normal contrast range increased from 25% to 80% following wavefront-guided repair (P<.05). For the control eyes, LASIK increased RAWS by 126% (RAWS was 122 µm p 2 preoperatively and 276 µm p 2 post-operatively). For the night vision disturbances repair eye group, RAWS at presentation was 104% (563 µm p 2 ) above the respective postoperative RAWS control eyes. Following wavefront-guided repair, RAWS was decreased (P<.05) to only 49% (410 µm p 2 ) above the postoperative control group. CONCLUSIONS: The RAWS parameter enabled a single digit descriptor of overall higher order aberrations for an eye over the principal physiological pupil range. By comparing RAWS parameter changes in wavefront-guided repair eyes to matched postoperative asymptomatic eyes, we were able to determine the magnitude of the deficit in the symptomatic eyes and the relative efficacy of wavefront-guided repair. [J Refract Surg. 2005;21: S535-S540.]

PurposeA retrospective comparison of refractive outcomes of a new, aspherically optimized profile with an enhanced energy correction feature (Triple-A) and the conventionally used aspherically optimized profile (ASA, or aberration smart ablation) for correction of low-to-high myopia.SettingAugen-OP-Centrum, Cologne, GermanyDesignRetrospective nonrandomized comparative studyMethodsA central database at the Augen-OP-Centrum was used to gather retrospective data for low-to-high myopia (up to −10 D). One hundred and seven eyes (56 patients) were treated with the ASA profile, and 79 eyes (46 patients) were treated with the Triple-A profile. Postoperative outcomes were evaluated at 1 month, 3 months, 6 months, and 1 year follow-up time points.ResultsThe Triple-A profile showed better predictability indicated by a significantly lower standard deviation of residuals (0.32–0.34 vs 0.36–0.44, Triple-A vs ASA) in the 6-month to 1-year period. The Triple-A group had better stability across all time intervals and achieved better postoperative astigmatism improvements with significantly lower scatter. This group achieved better safety at 1 year, with 100% of eyes showing no change or gain in Snellen lines, compared with 97% in the ASA group. A better safety index was observed for the Triple-A group at later time points. The Triple-A group had a better efficacy index and a higher percentage of eyes with an uncorrected Snellen visual acuity of 20/20 or greater at all investigated follow-up time points.ConclusionThe new aspherically optimized Triple-A profile can safely and effectively correct low-to-high myopia. It has demonstrated superiority over the ASA profile in most refractive outcomes.

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