Wavefront Optimized Versus Custom-Q Treatments in Surface Ablation for Myopic Astigmatism With the WaveLight ALLEGRETTO Laser

Abstract To compare treatments with wavefront optimized and custom-Q ablations. Two consecutive groups of eyes were treated for myopia and astigmatism with surface ablation. One group was treated with wavefront optimized ablation and the second group was treated with custom-Q ablation. Preoperative and 3-month postoperative Q-values, higher order aberrations, low contrast visual acuity, and classic outcome parameters were analyzed. The wavefront optimized ablation group was comprised of 46 eyes of 23 patients with a mean spherical equivalent refraction (SE) of -3.64 diopters (D) (range: -1.15 to -8.25 D); mean Q-value changed from -0.33 preoperatively to 0.06 postoperatively. The custom-Q ablation group was comprised of 42 eyes of 21 patients with a mean SE of -3.24 D (range: -1.47 to -8.00 D); mean Q-value changed from -0.36 preoperatively to -0.03 postoperatively. A statistically significant difference in postoperative change in Q-values (P = .049) between the two groups was noted, but there was no such difference in higher order aberrations, low contrast visual acuity, or classic outcome parameters. Custom-Q ablation resulted in a mean postoperative asphericity that was closer to preoperative compared to wavefront optimized ablation, whereas the other outcome parameters showed no statistically significant differences.