Q-factor customized ablation profile for the correction of myopic astigmatism

PURPOSE: To compare the results of the Q-factor customized aspheric ablation profile with the wavefront-guided customized ablation pattern for the correction of myopic astigmatism. SETTING: Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland. METHODS: Thirty-five patients were enrolled in a controlled study in which the nondominant eye was treated with the Q-factor customized profile (custom-Q study group) and the dominant eye was treated with wavefront-guided customized ablation (control group). Preoperative and 1-month postoperative high-contrast visual acuity, low-contrast visual acuity, and glare visual acuity, as well as aberrometry and asphericity of the cornea, were compared between the 2 groups. All eyes received laser in situ keratomileusis surgery, and the laser treatment was accomplished with the Wavelight Eye-Q 400 Hz excimer laser. RESULTS: For corrections up to −9 diopters (D) of myopia, there were no statistically significant differences between the 2 groups regarding any visual or optical parameter except coma-like aberrations (3rd Zernike order), where the wavefront-guided group was significantly better 1 month after surgery (P = .002). For corrections up to −5 D (spherical equivalent), the Q-factor optimized treated eyes had a significantly smaller shift toward oblate cornea: ΔQ15 = 0.25 in Q-factor customized versus ΔQ15 = 0.38 in wavefront-guided treatment (P = .04). CONCLUSIONS: Regarding safety and refractive efficacy, custom-Q ablation profiles were clinically equivalent to wavefront-guided profiles in corrections of myopia up to –9 D and astigmatism up to 2.5 D. Corneal asphericity was less impaired by the custom-Q treatment up to −5 D of myopia.