Clinical outcomes of topography-guided versus wavefront-optimized LASIK for correction of myopia and compound myopic astigmatism

Purpose: To compare the safety, efficacy, and visual outcomes of topography-guided (TG) LASIK ablation versus advanced ablation algorithm (AAA) on Zeiss Mel 90 on virgin eyes. Setting: A tertiary care hospital in north India. Design: A retrospective comparative study. Methods: Case sheets of 30 patients who underwent TG LASIK and 45 patients who underwent AAA LASIK between January 2021 and September 2022 were retrieved and reviewed. The TG group included 60 eyes of 30 patients, and the AAA group included age- and sex-matched 90 eyes of 45 patients. Both groups were compared for visual outcomes, residual refraction, and root-mean-square higher-order aberrations (rms HOA) at 1 week, 1 month, 3 months, and 6 months postoperatively and using unpaired t-test and Mann-Whitney U test. Results: The mean preoperative spherical equivalent in the TG group and AAA group was − 3.12 (1.67) and − 3.19 (1.61), respectively. The safety and efficacy of the treatment were 100% in both groups. The postoperative increase in rms HOA was comparable in both groups (P = 0.55). The ablation duration was significantly longer in topo-guided LASIK (P = 0.001). Conclusion: AAA LASIK on MEL 90 is comparable to topography-guided LASIK for the management of low myopia and myopic astigmatism.