To evaluate the effects of the amount of myopic correction on long-term changes in higher-order wavefront aberrations (HOAs) in advanced surface ablation-photorefractive keratectomy (ASA-PRK).

The 193 eyes of 101 patients who underwent ASA-PRK were divided into two groups according to the amount of myopic correction by the median value (Group 1 ≤ -4.37D, 97 eyes, mean -3.26 ± 0.77D; Group 2 > -4.37D, 96 eyes, mean -5.77 ± 1.00D). Wavefront aberrometry was performed to measure total HOA, coma, trefoil, and spherical aberration preoperatively and at 1, 3, 6, 12, and 24 months after ASA-PRK. Statistical analysis was performed to compare changes in all HOAs between the two groups.

Each magnitude of total HOA, coma, and spherical aberration except trefoil significantly increased at 1, 3, 6, 12, and 24 months postoperatively in each group ( p <0.05), and the increases were statistically significantly higher in group 2 compared to those of group 1 ( p <0.05). The amount of changes in all HOAs except trefoil revealed that statistically significantly higher increases in group 2 compared to those of group 1 were determined only in the short-term period (up to 1 month, p <0.05), but not in the medium-term (1 to 6 months) or long-term periods (6 to 24 months).

Postoperative total HOA, coma, and spherical aberration significantly increased in both groups, and these increases in surgery-induced HOAs were significantly higher in group 2 (> -4.37D). Increases in ASA-PRK-induced HOAs primarily originated from short-term changes in the postoperative one-month period and did not return to the preoperative level during the postoperative two-year period.