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Visual Quality Differences Between Orthokeratology and LASIK to Compensate LowModerate Myopia

Madrid-Costa, David PhD; García-Lázaro, Santiago PhD; Albarrán-Diego, César MSc; Ferrer-Blasco, Teresa PhD; Montés-Micó, Robert PhD

doi: 10.1097/ICO.0b013e31828d6d4d
Clinical Science

Purpose: To assess the differences in visual performance between orthokeratology (ortho-k) and laser in situ keratomileusis (LASIK) for the treatment of low-to-moderate myopia.

Methods: An adaptive optics visual simulator (Imagine Eyes) was used to simulate the wavefront aberration patterns induced by ortho-k and LASIK for low and moderate myopia on 10 healthy eyes. Visual acuity (VA) at 100%, 50%, and 10% contrast levels and contrast sensitivity (CS) at 10, 20 and 25 cycles per degree (cpd) were then measured for 3- and 6-mm pupil sizes.

Results: Differences in VA for 3-mm pupil diameter were not found between ortho-k and LASIK. For 6-mm pupil size, LASIK provided significantly better VA values than ortho-k at 50% and 10% contrast levels for low myopia correction (P = 0.002 and P = 0.001, respectively) and at all contrast levels for moderate myopia correction (P = 0.04 at 100%, P < 0.0001 for 50% and 10% contrast levels). For 3-mm pupil size, differences in CS were not significant between both techniques for low myopia correction and were only significant at 25 cpd (P = 0.03) for moderate myopia correction. For 6-mm pupil diameter, LASIK provided better CS than ortho-k for 20 and 25 cpd for low myopia (P = 0.02 and P = 0.01, respectively) and at all spatial frequencies for moderate myopia (P = 0.02 for 10 cpd and P < 0.0001 for 20 and 25 cpd).

Conclusions: The results in this study suggest that LASIK provides better visual quality outcomes than ortho-k for the treatment of low-to-moderate myopia.

Author Information

Optics Department, Faculty of Physics, University of Valencia, Valencia, Spain.

Reprints: David Madrid-Costa, Optometry Research Group, Department of Optics, University of Valencia, C/Dr Moliner, 50, 46100 Burjassot, Spain (e-mail:

Supported by a Ministerio de Ciencia e Innovación Research Grant (SAF 2009–13342) to R. Montés-Micó.

The authors have no conflicts of interest to disclose.

Received July 05, 2012

Accepted February 14, 2013

© 2013 by Lippincott Williams & Wilkins.