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Laser in situ keratomileusis for different degrees of myopia.

Lin JM, Tsai YY

Department of Ophthalmology, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung 404, Taiwan.

PURPOSE: To determine the efficacy, predictability, stability and safety of laser in situ keratomileusis (LASIK) in treating patients with different degrees of myopia. METHODS: We enrolled 386 eyes of 200 consecutive patients who underwent LASIK and divided them into four groups according to their degree of preoperative spherical equivalent (SE). Group 1 eyes ranged between - 1.00 and - 3.99 dioptres (D) (low myopia). Group 2 eyes ranged between - 4.00 and - 5.99 D (moderate myopia). Group 3 eyes ranged between - 6.00 and - 9.99 D (high myopia). Group 4 eyes were over - 9.99 D (extreme myopia). Follow-up was at 1 day, 1 week and 1, 3, 6, 12 and 18 months postoperatively. RESULTS: Our study included 386 eyes of 200 patients with SE ranging from - 3.00 to - 16.00 D (mean - 7.14 +/- 2.87 D). All eyes were seen at 1 day postoperatively. A total of 360 eyes (93%) were examined at 1 week, 330 eyes (85%) at 1 month, 281 eyes (73%) at 3 months, 247 eyes (64%) at 6 months, 199 eyes (52%) at 12 months and 142 eyes (37%) at 18 months. The postoperative data from 1 day to 12 months were used because of the low follow-up rate at 18 months postoperatively. Group 1 consisted of 30 eyes. The mean SE was - 3.52 +/- 0.43 D preoperatively and - 0.40 +/- 0.58 D at 1 month, - 0.46 +/- 0.60 D at 6 months and - 0.42 +/- 0.50 D at 12 months postoperatively. Uncorrected visual acuity (UCVA) was 20/40 or better in 95% of eyes at 1 day and in 100% of eyes at 6 and 12 months postoperatively. Group 2 consisted of 151 eyes. The mean SE was - 5.36 +/- 0.67 D preoperatively and - 0.54 +/- 0.78 D at 1 month, - 0.56 +/- 0.90 D at 6 months and - 0.55 +/- 0.82 D at 12 months postoperatively. Uncorrected VA was 20/40 or better in 95% of eyes at 1 day and in 100% of eyes at 6 and 12 months postoperatively. Group 3 consisted of 167 eyes. The mean SE was - 8.15 +/- 0.94 D preoperatively and - 0.58 +/- 0.90 D at 1 month, - 0.67 +/- 1.00 D at 6 months and - 0.64 +/- 0.95 D at 12 months postoperatively. Uncorrected VA was 20/40 or better in 90% of eyes at 1 day and in 98% of eyes at 6 and 12 months postoperatively. Group 4 consisted of 38 eyes. The mean SE was - 11.09 +/- 1.10 D preoperatively and - 1.25 +/- 1.20 D at 1 month, - 1.13 +/- 1.30 D at 6 months and - 1.20 +/- 1.25 D at 12 months postoperatively. Uncorrected VA was 20/40 or better in 78% of eyes at 1 day, in 94% at 6 months and in 90% at 12 months postoperatively. Intraoperative complications (free cap) occurred in two eyes and postoperative complications were observed in three eyes, making the total complications rate 1.29% (5/386). Seven eyes lost one Snellen line of BCVA, five lost two lines and two lost more than two lines (total: 3.64%, 14/386). CONCLUSION: In conclusion, LASIK is effective, predictable and safe for correcting myopia but is more accurate for correcting myopia up to -10.00 D. With more improvement in algorithms and ablation profile, we believe that LASIK can offer better results for higher myopia.

Published 17 February 2005 in Acta Ophthalmol Scand, 83(1): 40-5.
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