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To assess clinical results of three planning strategies-ZZ vector-compensative refraction (ZZ VR), clinical refraction (CR) and topography modified refraction (TMR) in the myopia and myopic astigmatism correction using topography-guided LASIK.
This was a prospective study. Consecutive patients were enrolled between November 2018 and February 2019 for topography-guided LASIK. Subjects were randomly treated with ZZ VR, CR or TMR strategy in topography-guided LASIK. The theory of ZZ VR was to consider both manifest refraction and refraction affected by high order aberrations (HOAs), and apply vector analysis to finalize correction on astigmatic power and axis. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), sphere, cylinder and spherical equivalent (SE) were assessed preoperatively and 1 day, 1 month, 3 months and 6 months postoperatively.
A total of 84 eyes in 43 patients were included. Among ZZ VR (n=35), TMR (n=24), and CR (n=25) strategies, cylinder at 6-month after surgery were -0.26±0.27 D, -0.61±0.32 D, and -0.38±0.22 D (P<0.001), respectively. For the comparison of cylinder between each two groups, there were significant differences at 1 day, 1 month and 3 months (all with P<0.05), and the differences between ZZ VR and CR were not significant at 2 weeks and 6 months after surgery (P=0.11 and P=0.16). UCVA at 6 months were -0.09±0.06, -0.05±0.06, and -0.08±0.05 (F=3.03, P=0.05), respectively, however, UCVA between TMR and the other two groups at the rest of follow-up visits were statistically significant (all P<0.05).
Compared to CR and TMR strategies, ZZ VR strategy offered superior outcomes in efficacy and predictability in topography-guided LASIK for myopia and myopic astigmatism correction.