PURPOSE To compare clinical outcomes between topography-guided customized ablation treatment (TCAT) and wavefront-optimized (WFO) laser in situ keratomileusis (LASIK) in fellow eyes of myopic patients. METHODS This prospective randomized contralateral study included 432 eyes of 216 myopic patients who underwent LASIK. TCAT was randomly performed in one eye (TCAT group) and WFO LASIK in the fellow eye (WFO group). The WaveLight FS200 femtosecond laser (Alcon Laboratories, Inc., Fort Worth, TX) was used to create the flap and the EX500 excimer laser was used for photoablation. The Sirius combined corneal topographer and tomographer system (CSO, Florence, Italy) was used to measure the corneal aberrations. Refractive and visual outcomes and corneal aberrations were compared between the two groups. RESULTS At 1 month postoperatively, the uncorrected distance visual acuity (UDVA) was 20/20 or better in 89.4% of eyes in the TCAT group and 93.5% of eyes in the WFO group (P < .05). The UDVA became similar at postoperative 6 months (P > .05). Postoperative corrected distance visual acuity and residual manifest refractive spherical equivalent were similar between the groups (P > .05). The postoperative residual refractive astigmatism in the TCAT group was greater than that in the WFO group (P < .05). The optical path difference and root mean square of higher order aberrations and coma were significantly lower in eyes in the TCAT group at postoperative 1 and 6 months (P < .05). CONCLUSIONS TCAT in virgin eyes induced less corneal optical path difference, fewer higher order aberrations, and less coma than WFO LASIK. However, TCAT was not as accurate as WFO, especially in astigmatism correction. A better compensation method for TCAT is warranted. [J Refract Surg. 2019;35(9):575-582.].

中文翻译：

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地形引导与波前优化FS-LASIK矫正近视和近视散光的随机比较研究。

目的比较近视眼患者的地形引导下定制消融治疗（TCAT）与波前优化（WFO）激光原位角膜磨镶术（LASIK）的临床结局。方法这项前瞻性随机对侧研究包括216例接受LASIK手术的近视患者的432只眼。TCAT在一只眼睛（TCAT组）中随机进行，而WFO LASIK在另一只眼睛（WFO组）中进行。WaveLight FS200飞秒激光器（德克萨斯州沃思堡的爱尔康实验室有限公司）用于制作襟翼，而EX500准分子激光器用于光烧蚀。Sirius组合了角膜地形图和断层成像系统（CSO，意大利佛罗伦萨），用于测量角膜像差。比较两组的屈光和视觉结果以及角膜像差。结果术后1个月，TCAT组的89.4％的眼睛和WFO组的93.5％的眼睛的未矫正远视力（UDVA）为20/20或更好（P <.05）。术后6个月的UDVA变得相似（P> .05）。两组之间的术后校正远视力和残余明显屈光球当量相似（P> .05）。TCAT组的术后残余屈光散光大于WFO组（P <.05）。术后1和6个月，TCAT组的眼睛的光程差和高阶像差和彗差的均方根显着降低（P <.05）。结论与WFO LASIK相比，原始眼睛中的TCAT引起的角膜光程差较小，高阶像差较小且昏迷程度较低。但是，TCAT不如WFO准确，特别是在散光矫正中。有必要为TCAT提供更好的补偿方法。[J Refract Surg。2019; 35（9）：575-582。]。