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Purpose <p>To evaluate whether modest differences in programmed ablation-zone diameter (AZD) during LASEK affect postoperative whole-corneal higher-order aberrations (HOAs), with emphasis on spherical aberration (SA) and coma (CA).</p> Methods <p>This retrospective single-center observational study included 120 right eyes that underwent LASEK between January 2020 and June 2025. Eyes were grouped by programmed AZD: 5.75&#xa0;mm (<i>n</i> = 41), 6.00&#xa0;mm (<i>n</i> = 40), and 6.25&#xa0;mm (<i>n</i> = 39). Corneal HOAs were measured by Pentacam at baseline, 1 and 3 months. Analyses included absolute changes, per-diopter normalization, SEQ-matched comparisons, and ablation-depth-matched sensitivity analyses.</p> Results <p>All groups showed significant postoperative increases in total HOA, SA and CA at 3 months (<i>P</i> &lt; 0.001). In unadjusted analyses, larger programmed AZDs exhibited smaller absolute increases in total HOA, SA and trefoil (<i>P</i> &lt; 0.001). After per-diopter normalization, most zone-dependent differences were largely attenuated (<i>P</i> &gt; 0.05 for most comparisons). SEQ-matched analyses showed that AZD enlargement reduced SA but tended to increase CA, without a uniform reduction in total HOA. After ablation-depth matching, larger programmed AZD was not associated with additional HOA induction.</p> Conclusions <p>In LASEK, larger programmed AZDs were associated with smaller unadjusted HOA and SA induction at 3 months; however, these associations were substantially influenced by baseline refractive magnitude and ablation depth. AZD selection should be individualized, balancing refractive correction, tissue removal, corneal safety, and centration strategy.</p>

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Effect of ablation-zone diameter on whole-corneal higher-order aberrations after LASEK: a retrospective study

  • 期刊论文

  • 发表日期：

    2026年7月2日

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  • Huihang Wang,
  • Lu Xu,
  • Zhizhou Chen,
  • Pu Ding,
  • Maijie Zhang,
  • Shumin Tang,
  • Yijun Lin,
  • Shaobin Zheng,
  • Yihua Zhu

摘要

Purpose

To evaluate whether modest differences in programmed ablation-zone diameter (AZD) during LASEK affect postoperative whole-corneal higher-order aberrations (HOAs), with emphasis on spherical aberration (SA) and coma (CA).

Methods

This retrospective single-center observational study included 120 right eyes that underwent LASEK between January 2020 and June 2025. Eyes were grouped by programmed AZD: 5.75 mm (n = 41), 6.00 mm (n = 40), and 6.25 mm (n = 39). Corneal HOAs were measured by Pentacam at baseline, 1 and 3 months. Analyses included absolute changes, per-diopter normalization, SEQ-matched comparisons, and ablation-depth-matched sensitivity analyses.

Results

All groups showed significant postoperative increases in total HOA, SA and CA at 3 months (P < 0.001). In unadjusted analyses, larger programmed AZDs exhibited smaller absolute increases in total HOA, SA and trefoil (P < 0.001). After per-diopter normalization, most zone-dependent differences were largely attenuated (P > 0.05 for most comparisons). SEQ-matched analyses showed that AZD enlargement reduced SA but tended to increase CA, without a uniform reduction in total HOA. After ablation-depth matching, larger programmed AZD was not associated with additional HOA induction.

Conclusions

In LASEK, larger programmed AZDs were associated with smaller unadjusted HOA and SA induction at 3 months; however, these associations were substantially influenced by baseline refractive magnitude and ablation depth. AZD selection should be individualized, balancing refractive correction, tissue removal, corneal safety, and centration strategy.