Transitioning to Optimized Correction with the WaveLight ALLEGRETTO WAVE: Case Distribution, Visual Outcomes, and Wavefront Aberrations

Abstract
Purpose: To describe the outcomes of the first 285 eyes receiving LASIK or photorefractive keratectomy (PRK) using an optimized ablation profile at a refractive surgery practice experienced with customized ablation. Methods: A retrospective chart review was performed on all patients who underwent refractive treatments using the ALLEGRETTO WAVE Eye-Q platform (Alcon Laboratories Inc) between September 2008 and July 2009. Patients were divided into LASIK and PRK treatments, then further subdivided based on pre- and targeted postoperative refraction. Pre- and postoperative measures of uncorrected distance visual acuity (UDVA), corrected distance visual acuity, manifest refraction, keratometry, and wavefront values were taken and compared, and the average changes in keratometry and higher order aberrations were calculated. Results: At 3 months postoperative, 92% of myopes and 63% of hyperopes undergoing LASIK with a target of emmetropia achieved UDVA of 20/20. Of PRK eyes targeted for emmetropia, 80% of myopic eyes achieved UDVA of 20/20 (the hyperopic subgroup was too small to analyze). In both LASIK and PRK subgroups, total wavefront aberrations decreased, as did some higher order aberrations. Conclusions: This group of patients, who all achieved excellent postoperative UDVA, represents our initial surgical experience with the ALLEGRETTO WAVE, using only a standard (global surgeon) nomogram. These results may serve as an estimate of what a practice could expect in terms of initial outcomes with this system.