{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T15:53:23Z","timestamp":1781884403151,"version":"3.54.5"},"reference-count":34,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>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 \u2265 520 \u00b5m, and normal corneal topography. HOAs were measured using Hartmann\u2013Shack 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 &lt; 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 &lt; 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.<\/jats:p>","DOI":"10.3390\/bioengineering13060685","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T03:27:21Z","timestamp":1781666841000},"page":"685","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Wavefront Outcomes After Femtosecond Laser Versus Mechanical Microkeratome Lasik: A Prospective Paired-Eye Comparative Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Sophie-Charlotte","family":"Drogge","sequence":"first","affiliation":[{"name":"Eye Clinic ORASIS, Swiss Eye Research Foundation, 5734 Reinach, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7977-0029","authenticated-orcid":false,"given":"Andreas J.","family":"Kreis","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5125-8840","authenticated-orcid":false,"given":"Ivo","family":"Guber","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Pajic","sequence":"additional","affiliation":[{"name":"Medical Faculty, Semmelweis University, 1094 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Canadanovic","sequence":"additional","affiliation":[{"name":"Medical Faculty, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8218-4899","authenticated-orcid":false,"given":"Zeljka","family":"Cvejic","sequence":"additional","affiliation":[{"name":"Department of Physics, Faculty of Sciences, University of Novi Sad, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6861-5851","authenticated-orcid":false,"given":"Martina","family":"Kropp","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Thumann","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eline","family":"De Clerck","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Resan","sequence":"additional","affiliation":[{"name":"Department of Physics, Faculty of Sciences, University of Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Faculty of Medicine of the Military Medical Academy, University of Defense, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan","family":"Resan","sequence":"additional","affiliation":[{"name":"Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1987-6232","authenticated-orcid":false,"given":"Bojan","family":"Pajic","sequence":"additional","affiliation":[{"name":"Eye Clinic ORASIS, Swiss Eye Research Foundation, 5734 Reinach, Switzerland"},{"name":"Division of Ophthalmology, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland"},{"name":"Experimental Ophthalmology, University of Geneva, 1205 Geneva, Switzerland"},{"name":"Department of Physics, Faculty of Sciences, University of Novi Sad, 21000 Novi Sad, Serbia"},{"name":"Faculty of Medicine of the Military Medical Academy, University of Defense, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.jcrs.2006.11.002","article-title":"Eleven-Year Follow-up of Laser in Situ Keratomileusis","volume":"33","author":"Kymionis","year":"2007","journal-title":"J. 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