Purpose To detect possible differences in clinical outcomes between wavefront-guided LASIK and wavefront-optimized LASIK for the treatment of myopia.
Methods A comprehensive literature search of Cochrane Library, MEDLINE and EMBASE to identify relevant trials comparing LASIK with wavefront-guided and wavefront-optimized. A meta-analysis was performed on the results of the reports. Statistical analysis was performed using RevMan 5.0 software.
Results Seven articles describing a total of 930 eyes were identified. There were no statistically significant difference in the final proportion of eyes achieving uncorrected distance visual acuity (UDVA) of 20/20 or better (OR, 1.04; 95% confidence interval(CI), 0.66 to 1.65; P = 0.86), manifest refractive spherical equivalent (SE) within ± 0.50 D of the target (OR, 0.96; 95% CI, 0.53 to 1.75; P = 0.90). No patient lost ≥ 2 lines of distance-corrected visual acuity (DCVA) at post-treatment. The changes in higher order aberrations (CHOAs) were no statistically significant difference between the two groups with preoperative RMS of < 0.3μm (WMD, 0.01; 95% CI, -0.02 to 0.04; P = 0.57). However, wavefront-guided had a significant better postoperative aberration profile than wavefront-optimized with preoperative RMS of > 0.3μm (WMD, -0.10; 95% CI, -0.15 to -0.06; P < 0.0001).
Conclusions Both wavefront-guided and wavefront-optimized LASIK have shown excellent efficacy, safety, predictability. The wavefront-guided treatments may have an advantage over wavefront-optimized in patients who have preoperative higher order aberrations (HOA) > 0.3 μm. | 
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