Wavefront-guided photorefractive keratectomy with and without iris registration: comparison of astigmatic correction

This study aimed to compare the visual outcomes after photorefractive keratectomy (PRK), with and without the iris registration (IR) technology. The retrospective cohort study was performed for wavefront-guided PRK using the Technolas 217z100 excimer laser system in patients with myopic astigmatism (cylinder error − 2 to − 4 diopter [D]). Eyes were divided into IR group (IRPRK) and non-IR group (non-IRPRK). Visual acuity (VA), cylindrical refraction, and the astigmatic vector components using the Alpins method were compared between the two groups preoperatively and 6 months postoperatively. Fifty IRPRK patients (66% female, mean age 30.56 ± 6.31 years) and 50 non-IRPRK (60% female, mean age 29.60 ± 5.63 years) were enrolled. The mean logMAR uncorrected VA improved from 0.89 ± 0.44 to 0.032 ± 0.05 in the IRPRK group (P < 0.001) and from 0.89 ± 0.46 to 0.042 ± 0.06 postoperatively while follow-up in the non-IRPRK group (P < 0.001). No statistically significant differences were observed between the two groups regarding mean uncorrected distance VA (P = 0.4), corrected distance VA (P = 0.5), spherical equivalent (P = 0.16), defocus equivalent (P = 0.18), and absolute cylinder (P = 0.94). More than 90% eyes were within ± 1.00 D of emmetropia in both groups. Moreover, Alpins vector analysis revealed that no significant differences were found in any astigmatic parameters between the two groups (P > 0.05). Wavefront-guided PRK independent of the IR status is effective, safe, and predictable in patients with myopic astigmatism. No statistical significance was observed supporting data for the better outcome of visual acuity and astigmatism correction using IR in comparison with a non-IR system.