Abstract
Purpose To evaluate changes in corneal anatomy and quality of vision following LASIK refractive surgery for mild to high myopia using the WaveLight® Refractive Suite (Alcon® Laboratories Inc., USA). Setting. Rothschild Foundation, Paris, France. Design Prospective interventional case series. Methods We examined 60 myopic eyes (average SE −4.5 D, from −9.3 to −0.75 D) of 30 patients from 21.3 to 38.7 years old. Pachymetry, keratometry, Q factor, corneal aberrations, visual acuity (VA), contrast sensitivity, dry eye assessment, and quality of vision were measured preoperatively, one day (D1), and 1, 3, and 6 months postoperatively. Results 6 months postoperatively, keratometry became flatter, and the Q factor became more oblate (from −0.18 ± 0.08 to +0.19 ± 0.06). Pachymetry decreased by 117.9 ± 62.2 µm at D1 and increased by 37.87 ± 32.6 µm between D1 and M6. Refraction was emmetropic at D1 and remained stable thereafter. Six months after surgery, VA was slightly but nonsignificantly improved (<0.05 log MAR), whereas contrast sensitivity remained unchanged. Quality of vision was not affected by surgery and was more related to dry eye symptoms than to corneal HOAs (r2 = 0.49; p < 0.001 vs. r2 = 0.03; p < 0.001). Conclusions LASIK surgery for moderate to high myopia, performed with the WaveLight® Refractive Suite, showed good postoperative outcomes, with demonstrated safety, predictability, efficiency, and stability. This is probably due to well-controlled spherical aberration and the use of large optical zones. Besides, we can assume that the patients' quality of vision depends more on the postoperative dry eye disease generated by the laser than on the induced HOAs.
Highlights
LASIK [1, 2] is an increasingly popular surgical option for the correction of myopia as demonstrated by the rising numbers of these procedures being performed worldwide.e technique involves use of a femtosecond laser to create a hinged flap, which is folded back to allow photoablation of the exposed stroma using an excimer laser
In the 1990s, many studies were published on the correction of myopia with LASIK [8, 9] reporting low predictability, significant regression, and induced night vision disturbances [10, 11]. ese issues were due in large part to the use of small optical zones [12, 13] and nonaspheric Munnerlyn ablation profiles leading to significant induced spherical aberrations [14]
In the 2000s, other studies Journal of Ophthalmology reported that LASIK was a safe and predictable method to correct moderate to high myopia [15, 16]
Summary
LASIK [1, 2] is an increasingly popular surgical option for the correction of myopia as demonstrated by the rising numbers of these procedures being performed worldwide. In the 1990s, many studies were published on the correction of myopia with LASIK [8, 9] reporting low predictability, significant regression, and induced night vision disturbances [10, 11]. Journal of Ophthalmology reported that LASIK was a safe and predictable method to correct moderate to high myopia [15, 16] These studies show a high success rate, reflected by favourable functional outcomes [17,18,19,20], and high physician and patient satisfaction [21]. Biomechanical corneal response (both anterior and posterior surfaces), visual performance (visual acuity, contrast sensitivity, and depth of focus), total and corneal aberrations, and patient satisfaction before and after LASIK. We aimed to correlate all these parameters to obtain a more complete view of the present outcomes of LASIK surgery in moderate to high myopia with the aforementioned devices
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