Refractive assessment by wavefront aberrometry compared to subjective refraction in PRK patients.

Abstract

Purpose: To compare wavefront aberrometry (WA) refraction with subjective refraction (SR) before and after transepithelial photorefractive keratectomy (tPRK) or combined phototherapeutic keratectomy (PTK)-PRK.

Methods: In our monocentric retrospective study, we aimed to compare refraction measurements obtained using wavefront aberrometry (WA) with subjective refraction (SR) for 154 eyes that underwent PRK treatment. The eyes underwent either tPRK treatment with the Amaris750 excimer laser or combined PTK-PRK treatment with the MEL90 excimer laser. Preoperative spherical equivalent, age, and sex were matched between the two groups. Wavefront measurements were performed with Sirius in tPRK patients and with WASCA in PTK-PRK patients. Follow-up was 6 months postoperatively. We used Bland-Altman plots and intraclass coefficient (ICC) analysis to demonstrate the agreement of SR and WA refraction.

Results: Preoperatively, there was a high agreement between WA and SR refraction in both treatment groups. However, postoperatively, there was almost no agreement between the two methods (ICC = 0). WA refraction provided more significant hyperopic refraction values postoperatively, while the agreement for cylinder values was lower compared to the sphere.

Conclusion: Our study shows that the choice of refraction measurement method should be carefully considered in PRK patients, particularly in the postoperative period and when using aberrometry systems. Further research with larger sample sizes is needed to fully investigate this topic.