Corneal wavefront-guided retreatments for significant night vision symptoms after myopic laser refractive surgery.

PURPOSE: To evaluate the results of corneal wavefront (WF)-guided enhancements in patients with night vision symptoms and significantly high positive spherical aberration (SA) after myopic laser refractive surgery.

DESIGN: Noncomparative, interventional case series.

METHODS: Twenty-eight eyes of 20 patients with significant night vision symptoms and positive corneal SA (Z(4)(0)) higher than 0.5 microm after myopic laser refractive surgery were included in the study at Vissum-Instituto Oftalmologico de Alicante, Spain. Enhancement surgery was planned to remove residual refractive error and corneal SA (Z(4)(0)) in all cases. All patients underwent corneal WF-guided excimer laser retreatments using the ESIRIS/SCHWIND excimer laser system (Schwind Eye Tech Solutions, Kleinostham, Germany). The main outcome measures were visual symptoms, change in corneal SA (Z(4)(0)), and corneal asphericity (Q-value).

RESULTS: Subjective reports of night vision symptoms were improved in all patients. Mean corneal SA (Z(4)(0)) decreased from 0.75 +/- 0.19 microm before surgery to 0.43 +/- 0.42 microm after surgery (P < .001). Mean asphericity in the 4.5-mm zone significantly decreased from 1.02 +/- 1.07 before surgery to 0.52 +/- 0.88 after surgery (P = .008), and the mean asphericity in 8 mm did not change significantly (P = .362). The mean spherical equivalent significantly shifted to hyperopia from -0.22 +/- 1.14 diopters (D) before surgery to 0.33 +/- 0.54 D after surgery (P = .025).

CONCLUSIONS: Cornea wavefront-guided retreatment was effective in improving subjective night vision symptoms, reducing corneal SA, and decreasing asphericity in eyes that underwent myopic laser refractive surgery.