To evaluate the visual outcome and change in higher-order aberrations (HOAs) 1 year post simultaneous wavefront-guided and aspheric photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK).

Prospective interventional case series.

Consecutive myopic patients undergoing PRK (38 eyes of 23 patients) and LASIK (42 eyes of 25 patients) using the Technolas 217z100 excimer laser (Technolas Perfect Vision) in a private laser clinic were included. Main outcome measures were uncorrected distance visual acuity (UDVA), manifest refraction (MRSE), HOAs, and spherical aberration (Z₄⁰).

At 1 year, 87% (32/37) of PRK eyes and 81% (30/37) of LASIK eyes had UDVA of 20/20 or better (P = .75). Mean ± SD MRSE was −0.26 ± 0.31 diopters (D) in the PRK and −0.16 ± 0.34 D in the LASIK group (P = .222). There was no significant increase in total HOA root mean square (RMS) in the PRK group. Mean ± SD total HOA RMS increased from 0.402 ± 0.14 μm to 0.496 ± 0.17 μm (P = .013) in the LASIK group at 1 year. Z₄⁰ increased from mean ± SD −0.045 ± 0.12 μm to −0.109 ± 0.15 μm (P = .006, factor 2.42) in the PRK group and did not significantly increase in the LASIK group (mean ± SD −0.16 ± 0.17 μm to −0.17 ± 0.15 μm (P = .469, factor 1.08) at 6 mm pupil.

Visual outcome was excellent in both treatment groups. HOAs were still increased following LASIK by a factor of 1.23 but not PRK. Z₄⁰ was not induced by LASIK with the treatment algorithm but was negatively induced in PRK eyes.