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Bioengineering
Volume 13
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10.3390/bioengineering13060685
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Clinical and Wavefront Outcomes After Femtosecond Laser Versus Mechanical Microkeratome Lasik: A Prospective Paired-Eye Comparative Study

by
Sophie-Charlotte Drogge
1,†,
Andreas Kreis
2,3,†,
Ivo Guber
2,3,
Valentin Pajic
4,
Vladimir Canadanovic
5,
Zeljka Cvejic
6,
Martina Kropp
2,3,
Gabriele Thumann
2,3,
Eline De Clerck
2,3,
Mirko Resan
6,7,
Bogdan Resan
8 and
Bojan Pajic
1,2,3,6,7,*
1
Eye Clinic ORASIS, Swiss Eye Research Foundation, 5734 Reinach, Switzerland
2
Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland
3
Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland
4
Medical Faculty, Semmelweis University, 1094 Budapest, Hungary
5
Medical Faculty, University of Novi Sad, 21137 Novi Sad, Serbia
6
Department of Physics, Faculty of Sciences, University of Novi Sad, 21000 Novi Sad, Serbia
7
Faculty of Medicine of the Military Medical Academy, University of Defense, 11000 Belgrade, Serbia
8
Medical Faculty, University of Belgrade, 110000 Belgrade, Serbia
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Bioengineering 2026, 13(6), 685; https://doi.org/10.3390/bioengineering13060685 (registering DOI)
Submission received: 30 April 2026 / Revised: 11 June 2026 / Accepted: 12 June 2026 / Published: 14 June 2026
(This article belongs to the Section Biomedical Engineering and Biomaterials)
Versions Notes

Abstract

Background/Objectives: The technique used for flap creation in laser in situ keratomileusis (LASIK) may influence postoperative optical quality and visual outcomes. This prospective randomized paired-eye study compared higher-order aberrations (HOAs) and visual acuity outcomes following femtosecond laser-assisted versus mechanical microkeratome-assisted LASIK. Materials and Methods: Forty-four patients (88 eyes) underwent bilateral LASIK. In each patient, one eye was randomly assigned to high-frequency femtosecond laser flap creation (Femto LDV), and the fellow eye to mechanical microkeratome flap creation (Amadeus II). Inclusion criteria were stable refraction, central corneal thickness ≥ 520 µm, and normal corneal topography. HOAs were measured using Hartmann–Shack wavefront aberrometry over a 6 mm pupil diameter. Uncorrected and corrected distance visual acuity (UDVA and CDVA) were evaluated preoperatively and postoperatively at 1 day, 1 week, and 1, 3, and 6 months. Results: Both techniques induced significant postoperative changes in specific Zernike coefficients and an increase in total HOA root mean square (RMS) values (p < 0.05). A reduction in spherical aberration (Z4,0) was observed in both groups, while technique-specific changes were noted in individual aberration components including an increase in horizontal trefoil (Z3,3) in the femtosecond and a decrease in horizontal coma (Z5,1) in the microkeratome group. However, paired-eye comparisons revealed no statistically significant differences in total HOA six months postoperative. Despite comparable aberrometric outcomes, femtosecond-treated eyes demonstrated significantly better UDVA and CDVA at all postoperative time points (p < 0.05). Conclusions: Femtosecond laser-assisted and microkeratome-assisted LASIK resulted in comparable changes in higher-order aberrations, despite differing pattern in individual aberration components. The observed differences in visual acuity outcomes were not reflected in wavefront metrics, suggesting that postoperative visual performance may be influenced by factors.
Keywords: LASIK; femtosecond laser; mechanical microkeratome; high-order aberration; wavefront analysis; visual acuity LASIK; femtosecond laser; mechanical microkeratome; high-order aberration; wavefront analysis; visual acuity

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MDPI and ACS Style

Drogge, S.-C.; Kreis, A.; Guber, I.; Pajic, V.; Canadanovic, V.; Cvejic, Z.; Kropp, M.; Thumann, G.; De Clerck, E.; Resan, M.; et al. Clinical and Wavefront Outcomes After Femtosecond Laser Versus Mechanical Microkeratome Lasik: A Prospective Paired-Eye Comparative Study. Bioengineering 2026, 13, 685. https://doi.org/10.3390/bioengineering13060685

AMA Style

Drogge S-C, Kreis A, Guber I, Pajic V, Canadanovic V, Cvejic Z, Kropp M, Thumann G, De Clerck E, Resan M, et al. Clinical and Wavefront Outcomes After Femtosecond Laser Versus Mechanical Microkeratome Lasik: A Prospective Paired-Eye Comparative Study. Bioengineering. 2026; 13(6):685. https://doi.org/10.3390/bioengineering13060685

Chicago/Turabian Style

Drogge, Sophie-Charlotte, Andreas Kreis, Ivo Guber, Valentin Pajic, Vladimir Canadanovic, Zeljka Cvejic, Martina Kropp, Gabriele Thumann, Eline De Clerck, Mirko Resan, and et al. 2026. "Clinical and Wavefront Outcomes After Femtosecond Laser Versus Mechanical Microkeratome Lasik: A Prospective Paired-Eye Comparative Study" Bioengineering 13, no. 6: 685. https://doi.org/10.3390/bioengineering13060685

APA Style

Drogge, S.-C., Kreis, A., Guber, I., Pajic, V., Canadanovic, V., Cvejic, Z., Kropp, M., Thumann, G., De Clerck, E., Resan, M., Resan, B., & Pajic, B. (2026). Clinical and Wavefront Outcomes After Femtosecond Laser Versus Mechanical Microkeratome Lasik: A Prospective Paired-Eye Comparative Study. Bioengineering, 13(6), 685. https://doi.org/10.3390/bioengineering13060685

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