A Prospective Study Analyzing Wavefront-Guided LASIK and PRK Surgery Performed by Cornea Fellows in Training

Purpose: To evaluate visual outcomes in patients with myopia or compound myopic astigmatism in wavefront-guided laser in situ keratomileusis (WFG-LASIK) and photorefractive keratectomy (WFG-PRK) performed by cornea fellows in training. Setting: Academic eye institute in Palo Alto, California, USA Design: Prospective, nonrandomized clinical trial Methods: Patients with no history of refractive surgery underwent WFG-LASIK or WFG-PRK. Patients had preoperative refractive errors with sphere up to -10.25 diopters (D), cylinder up to 4.50 D, with a maximum spherical equivalent (SE) of -10.00 D. All eyes were targeted for emmetropia. The primary outcome measure was UDVA at 3 months. Secondary outcome measures included safety and predictability. Results: 66 eyes of 33 patients underwent WFG-LASIK, and 71 eyes of 36 patients underwent WFG-PRK from March 2017 to October 2024. At 3 months, 91.2% of eyes in the WFG-LASIK group achieved UDVA of 20/20 or better, 35.3% of eyes achieved 20/15 or better, 91.2% of eyes achieved manifest refraction SE (MRSE) within 0.50 D of target, mean SE was -0.04, and no eyes lost more than 2 lines of corrected distance visual acuity (CDVA). In patients who underwent WFG-PRK, 82.0% of eyes achieved UDVA of 20/20 or better, 10.0% of eyes achieved 20/15 or better, 98.0% of eyes achieved MRSE within 0.50 D of target, mean SE was -0.01, and no eyes lost more than 2 lines of CDVA. Conclusions: WFG-LASIK and WFG-PRK performed by cornea fellows in training achieved excellent safety, efficacy, and predictability for the correction of myopia and compound myopic astigmatism.