Factors Affecting Long-term Myopic Regression after Laser In Situ Keratomileusis and Laser-assisted Subepithelial Keratectomy for Moderate Myopia
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Purpose: High myopia is known to be a risk factor for long-term regression after laser refractive surgery. Therehave been few studies about the correction of moderate myopias that did not need retreatment after long-termfollow-up. We evaluated 10 years of change in visual acuity and refractive power in eyes with moderate myopiaafter laser refractive surgery. Methods: We included patients that had undergone laser in situ keratomileusis (LASIK) or laser-assisted subepithelialkeratectomy (LASEK) to correct their myopia and that had at least 10 years of follow-up. We evaluatedthe stability of visual acuity in terms of safety, efficacy, and refractive changes at examinations 6 months and 1,2, 5, 7, and 10 years after surgery. Results: The study evaluated 62 eyes (36 eyes in LASIK patients and 26 eyes in LASEK patients). In bothgroups, the efficacy index tended to decrease, and it was consistently higher in the LASEK group comparedto the LASIK group over the 10 years of follow-up. The safety index improved over 10 years and was alwayshigher than 0.9 in both groups. The difference between the spherical equivalent at 6 months postoperativelyand later periods was statistically significant after 5, 7, and 10 years in both groups (LASIK, p = 0.036, p = 0.003,and p < 0.001, respectively; LASEK, p = 0.006, p = 0.002, and p = 0.001, respectively). Ten years after surgery,26 eyes (66.7%) in the LASIK group and 19 eyes (73.1%) in the LASEK group had myopia greater than1 diopter. In comparison with the thickness at 6 months postoperatively, central corneal thickness was significantlyincreased after 5, 7, and 10 years in both LASIK and LASEK groups (LASIK, p < 0.001, p < 0.001, and p< 0.001, respectively; LASEK, p = 0.01, p < 0.001, and p < 0.001, respectively). Conclusions: Moderately myopic eyes showed progressive myopic shifting and corneal thickening afterLASIK and LASEK during 10 years of follow-up. We also found that early refractive regression may indicatethe long-term refractive outcome.
Abstract
Purpose: High myopia is known to be a risk factor for long-term regression after laser refractive surgery. Therehave been few studies about the correction of moderate myopias that did not need retreatment after long-termfollow-up. We evaluated 10 years of change in visual acuity and refractive power in eyes with moderate myopiaafter laser refractive surgery. Methods: We included patients that had undergone laser in situ keratomileusis (LASIK) or laser-assisted subepithelialkeratectomy (LASEK) to correct their myopia and that had at least 10 years of follow-up. We evaluatedthe stability of visual acuity in terms of safety, efficacy, and refractive changes at examinations 6 months and 1,2, 5, 7, and 10 years after surgery. Results: The study evaluated 62 eyes (36 eyes in LASIK patients and 26 eyes in LASEK patients). In bothgroups, the efficacy index tended to decrease, and it was consistently higher in the LASEK group comparedto the LASIK group over the 10 years of follow-up. The safety index improved over 10 years and was alwayshigher than 0.9 in both groups. The difference between the spherical equivalent at 6 months postoperativelyand later periods was statistically significant after 5, 7, and 10 years in both groups (LASIK, p = 0.036, p = 0.003,and p < 0.001, respectively; LASEK, p = 0.006, p = 0.002, and p = 0.001, respectively). Ten years after surgery,26 eyes (66.7%) in the LASIK group and 19 eyes (73.1%) in the LASEK group had myopia greater than1 diopter. In comparison with the thickness at 6 months postoperatively, central corneal thickness was significantlyincreased after 5, 7, and 10 years in both LASIK and LASEK groups (LASIK, p < 0.001, p < 0.001, and p< 0.001, respectively; LASEK, p = 0.01, p < 0.001, and p < 0.001, respectively). Conclusions: Moderately myopic eyes showed progressive myopic shifting and corneal thickening afterLASIK and LASEK during 10 years of follow-up. We also found that early refractive regression may indicatethe long-term refractive outcome.
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