The Changes of Posterior Corneal Surface and High-Order Aberrations after Refractive Surgery in Moderate Myopia

PURPOSE To compare forward shift of posterior corneal surface and higher-order aberration (HOA) changes after LASIK, LASEK, and wavefront-guided LASEK surgery in moderate myopia METHODS One hundred eighty four eyes undergoing LASIK, LASEK and wavefront-guided LASEK with VISX STAR S4 were included in this study. The posterior corneal elevation was measured with Orbscan before, 2 and 4 months after surgery. Changes of the elevation were assessed using the difference map generated from preoperative and postoperative elevation maps. The values of higher-order aberrations were evaluated preoperatively and 2 months postoperatively with Wavefront aberrometer. RESULTS The posterior corneal surface displayed forward shift of 27.2+/-11.45 micrometer, 24.3+/-9.76 micrometer in LASIK group, 23.4+/-10.5 micrometer, 23.6+/10.55 micrometer in LASEK group, 24.0+/-14.95 micrometer, 28.4+/-14.72 micrometer in wavefront-guided LASEK group at 2 months and 4 months, respectively. There were no statistically significant differences among those three groups, and between 2 and 4 months. The root mean score (RMS) of HOA was increased after LASIK and LASEK (p=0.000, p=0.000, respectively). The mean change of HOA-RMS was significantly smaller in wavefront-guided LASEK than LASIK or LASEK (p=0.000, p=0.000, respectively, Bonferroni-corrected). CONCLUSIONS The changes of posterior corneal surface forward shift showed no difference among LASIK, LASEK and wavefront-guided LASEK in moderate myopia. HOAs were significantly increased after LASIK and LASEK. The changes of HOAs were significant smaller in wavefront-guided LASEK than LASIK or LASEK.