Visual Quality After LASIK: A Comparative Study of Topography-Guided and Wavefront-Optimized Treatments

Abstract

The 64th Annual Medical Student Research Forum at UT Southwestern Medical Center (Tuesday, January 27, 2026, 3-6 p.m., D1.700)PURPOSE: Two major methods of LASIK surgery, Topography-guided LASIK (TG-LASIK) and Wavefront-optimized LASIK (WFO-LASIK), use different optimization approaches. Both have been shown to be safe procedures that improve visual outcomes. The aim of this study is to investigate whether aberrations and visual disturbances differ significantly between the two LASIK treatment methods. PATIENTS AND METHODS: This was a retrospective clinical study that utilized chart review of patients who underwent TG-LASIK or WFO-LASIK at Laser Center for Vision Care at UT Southwestern between 2010 and 2024. A total of 161 eyes were analyzed, with 58 undergoing TG-LASIK and 103 undergoing WFO-LASIK. The measured outcomes included best-corrected visual acuity (BCVA), higher-order aberrations (HOAs), and self-reported visual symptoms. RESULTS: At 1-month post-op, TG-LASIK resulted in significantly better visual improvement compared to WFO-LASIK. While both treatment methods showed postoperative improvement in visual acuity, TG-LASIK was associated with more favorable 1-month visual outcomes. The WFO group had a higher percentage of eyes associated with reported postoperative visual symptoms or complications when compared to the TG group (52.5% vs. 29.3%, respectively; p = 0.0077). Ocular dryness was the most commonly reported symptom in both groups. CONCLUSIONS: TG-LASIK was found to have better 1-month visual outcomes and fewer postoperative symptoms compared to WFO-LASIK. Although both methods remain safe and effective options, TG-LASIK may provide better short-term improvements in visual quality and patient comfort in appropriately selected cases.Southwestern Medical Foundatio