Patient-Reported Quality of Vision in a Prospective Trial of Wavefront-Guided LASIK and PRK Performed by Corneal Fellows in Training.

Abstract

Purpose: To evaluate patient-reported outcomes following wavefront-guided laser in situ keratomileusis (WGF-LASIK) and photorefractive keratectomy (WFG-PRK) performed by corneal fellows in training.

Methods: In this prospective, nonrandomized clinical trial, 66 eyes of 33 patients underwent WFG-LASIK and 71 eyes of 36 patients underwent WFG-PRK at one institution. Main outcomes included results from the Patient-Reported Outcomes with LASIK (PROWL) questionnaire at the postoperative 3-month visit.

Results: At 3 months postoperatively, self-reported worry related to vision (LASIK, P < .001; PRK, P < .001), work productivity (P < .001 for both), and ability to perform activities (LASIK, P = .03; PRK, P < .001) significantly improved after surgery. The prevalence of double images, glare, halos, and starbursts decreased from 65% preoperatively to 56% in the LASIK group and from 74% preoperatively to 34% in the PRK group. Only 5% and 4% of participants reported "very" or "extremely bothersome visual symptoms in the LASIK and PRK groups, respectively, and no patients reported significant difficulty performing activities due to double images, glare, halos, or starbursts. Dry eye symptoms per Ocular Surface Disease Index score were similar preoperatively and at month 3 in both the LASIK and PRK groups. A total of 88.2% and 96.0% of participants were satisfied with their visual outcome after LASIK or PRK, respectively.

Conclusions: WFG-LASIK or WFG-PRK performed by corneal fellows in training yielded marked improvements in the presence and severity of most visual symptoms. Vision-related quality of life metrics significantly improved, and overall satisfaction in this study was high.