To evaluate and compare of clinical outcomes of wavefront optimized PRK and corneal wavefront guided (CWG) PRK in Schwind Aramis 1050 rs for correcting myopic astigmatism.

This prospective clinical trial study comprised 50 virgin eyes (32 patients) with compound myopic astigmatism.Myopia was considered between 1 to 8 diopters and astigmatism was considered between 1 to 3 diopters. Patients' eyes were randomly divided into two groups: wavefront optimized with Static Cyclotorsion and Corneal wavefront guided. All PRK refractive surgeries were done with Schwind Aramis 1050rs laser excimer. Visual acuity, refractive error, vector analysis, corneal topography, aberrometry and corneal asphericity were measured before and 6 months after surgery. The results were compared between the two groups.

Six months after surgery, the mean logMAR uncorrected distance visual acuity was similar in the WFO (0 ± 0.07) and CWG (0.01 ± 0.08) groups (P=0.611). Safety, efficacy, and predictability of refractive and visual outcomes were comparable between groups.Mean spherical equivalent refraction was 0.03 ± 0.16D and 0.02 ± 0.25D in the WFO and CWG groups (P=0.869), respectively.The correction indices were 0.976 ± 0.068 and 1.042 ± 0.191 in the WFO and CWFG groups (P=0.109). The absolute values of the angle of error were 1.296 ± 4.775 and 2.366 ± 6.016 in the WFO and CWG groups (P=0.489).Corneal coma aberration at a 6.0 mm pupil diameter increased in both groups (P > 0.05), the change was similar in two groups (P=0.96).Corneal spherical aberration at a 6.0 mm pupil diameter increased in both groups (P > 0.05), this change was lower in CWG group (P=0.302).Corneal asphericity increased in two group (P<0.001), this increased was higher in WFO group.

Using the Schwind Aramis 1050rs laser eximer for PRK was similar between WFO and CWG ablations in eyes with myopic astigmatism.