higher-order aberration changes and visual outcomes after wavefront-guided surface ablation excimer surgery in hyperopia and hyperopic astigmatism

purpose: to investigate the effects of surface ablation excimer surgery on higher-order aberrations and to assess the safety and efficacy of wavefront-guided surface ablation excimer surgery in patients with hyperopia and hyperopic astigmatism. methods: in this analytical & descriptive study, wavefront-guided surface ablation excimer surgery was performed in 58 eyes of 31 patients with hyperopia and hyperopic astigmatism. preoperative mean manifest spherical equivalent refraction was +2.09±1.19 d (range, +0.75 to +5.00 d) and mean refractive astigmatism was 1.00±1.11 d (range, 0.00 to 3.00 d). all patients underwent wavefront-guided surface ablation (wfg-sa). the outcome measures included preoperative and 6-month postoperative uncorrected visual acuity (ucva), best-spectacle corrected visual acuity (bscva), subjective refraction, and higher-order aberrations (coma, trefoil, spherical aberration, secondary astigmatism, quadrafoil, pentafoil, and total). the higher-order aberrations were measured through 6.00 mm pupils by the zywave ii aberrometer. the mean higher-order aberrations were compared pre- and postoperatively to describe the impact of surgery on the optical quality. results: there was no significant difference between preoperative and postoperative trefoil (p=0.097). however, the difference in pre- and postoperative coma, secondary astigmatism, quadrafoil, and pentafoil was statistically significant (p<0.05). there was a significant increase in spherical aberration after surgery (p=0.005) which demonstrated a shift toward negative values (opposite sign). conclusion: wfg-sa for hyperopia increased the coma, secondary astigmatism, spherical aberration, quadrafoil, pentafoil and total higher order aberrations. there was a 1.74-fold increase in total hoa after hyperopic wfg-sa which was statistically significant.