Skip to main content
  • Refractive Mgmt/Intervention

    Review of: Wavefront-guided PRK treatment of myopia using a refractive aberrometer

    Hofmeister E, Cason J, Murdoch D, et al. Journal of Cataract & Refractive Surgery, March 2023

    In this 12-month study of low-to-moderately myopic eyes, wavefront-guided photorefractive keratectomy (PRK) was found not only to be a safe and successful treatment option but also one that left 99% of patients highly satisfied.

    Study design

    This was a multicenter study of 334 eyes (167 patients) with myopic refractive errors that underwent wavefront-guided PRK with the STAR S4 IR Excimer Laser System using treatment plans derived from the iDESIGN system (Johnson & Johnson Vision) wavefront measurements. Patients received a baseline examination and surgery, followed by postoperative visits at 1 day, 1 week, 1 month, 3 months, 6 months, 9 months, and 12 months.


    By 6 months postoperatively, uncorrected distance visual acuity (UDVA) of 20/20 or better was achieved in 99.4% of eyes, UDVA of 20/16 or better was achieved in 92.0% of eyes, and manifest refraction spherical equivalent within 0.50 D of target was reached in 85.5% of eyes. Similar results were noted at 12 months. In addition, there was minimal induction of higher-order aberrations using wavefront-guided technologies and a high patient satisfaction of 98.8%.


    While these results were compared to those of other studies looking at wavefront-guided LASIK outcomes, it was not a comparison study or randomized controlled trial, so results cannot be directly compared. However, the reported results appear promising and similar to results achieved from LASIK, with a higher reported rate of patient satisfaction (95.5%) than another large retrospective study (91%).1

    Clinical significance

    Wavefront-guided LASIK using the Hartmann–Shack wavefront aberrometer has been reported to have high predictability and efficacy with LASIK, but applications of this technology with PRK have not been widely studied. This is the largest prospective study looking at wavefront-guided PRK using the iDESIGN system and demonstrates that this procedure is highly predictable and safe for the correction of low-to-moderate myopia.

    Financial Disclosures: Dr. Michele Lee discloses no financial relationships.

    1 Schallhorn S, et al. Journal of Ophthalmology. 2015:514839