Comparison of higher-order aberrations after LASEK with a 6.0 mm ablation zone and a 6.5 mm ablation zone with blend zone

Purpose: To compare the higher-order aberrations (HOAs) after laser-assisted subepithelial keratectomy (LASEK) using a conventional optical zone and a larger zone with a blend zone. Setting: Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. Methods: In this prospective study, 19 patients with a manifest refraction of -3.00 to -8.25 diopters (D) were treated with LASEK using a conventional (6.0 mm) optical zone in 1 eye and a larger (6.5 mm) zone with 8.0 mm blend zone in the other eye. The patients were followed for 3 months. Pupil size, best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), manifest refraction, corneal topography, pachymetry, and wavefront aberration were examined preoperatively; BCVA, UCVA, manifest refraction, and wavefront aberration were measured 1 and 3 months postoperatively. The Hartmann-Shack aberrometer (WaveScan®, Visx) was used to measure the overall wavefront aberrations in scotopic pupils. Results: There were no significant differences in preoperative pupil size, BCVA, UCVA, and manifest refraction between the 2 groups or in postoperative BCVA, UCVA, and refraction. Higher-order aberrations increased at 1 and 3 months in both eyes compared with preoperatively. At 3 months, in a scotopic pupil, the mean root-mean-square wavefront error of the HOAs was 0.41 ± 0.14 in the eyes treated with the larger optical zone and 0.61 ± 0.28 in those treated with the conventional optical zone. There was a significant difference between optical zones (P = .006). The difference was more pronounced in the treatment of myopia greater than -5.0 D (P = .001). Conclusions: In the scotopic condition, HOAs after LASEK using a large optical zone with blend zone ablation were smaller than those associated with conventional ablation zone treatment. The larger zone with blend zone treatment may be a good surgical alternative for better visual outcomes in scotopic conditions.