Abstract
INTRODUCTION: To assess the efficacy and safety of topography-guided LASIK (TG-LASIK) in correcting myopia and astigmatism and to evaluate clinical outcomes and visual quality postoperatively. METHODS: We conducted a prospective study including patients aged 18-40 years with stable refraction for over 12 months. The outcomes measured were uncorrected distance visual acuity (UDVA), contrast sensitivity, higher-order aberrations (HOAs), and patient-reported visual quality using a validated Quality of Vision (QoV) questionnaire. RESULTS: A total of 86 eyes of 43 patients were analyzed. At 12 months postoperatively, 97% of the eyes achieved a UDVA of 20/20 or better, and 99% maintained or improved their corrected distance visual acuity (CDVA). The mean UDVA remained stable over time (p > 0.05). The correction index for astigmatism was 0.99, with a strong correlation between target-induced astigmatism (TIA) and surgically induced astigmatism (SIA) (R (2) = 0.9751). Contrast sensitivity improved significantly at all spatial frequencies postoperatively (p < 0.05) and remained stable after 6 months. The QoV questionnaire revealed that blurred vision and fluctuations in vision were the most frequently reported symptoms, with fluctuation being the most bothersome. HOAs and coma increased significantly after surgery (p < 0.05), whereas lower-order aberrations (LOAs) and spherical aberration remained unchanged (p > 0.05). CONCLUSIONS: TG-LASIK is an effective approach in personalized refractive surgery, demonstrating safety and efficacy in improving visual quality for myopia and astigmatism. The improvement in visual quality, despite an increase in HOAs, suggests the effectiveness of personalized ablation profiles.