Abstract

Objective To evaluate the clinical effects of Laser in situ keratomileusis (LASIK) with different ablation patterns united for ultra-high myopia using VISX S4 excimer laser. Methods Retrospectively analyzed 120 ultra-high myopia patients (216 eyes) corrected by LASIK using VISX S4 excimer laser, depended on the ablation pattern, divided them into the ESB group (M Ellipse+ M Sphere +M Blend) in 74 eyes, ART (Advanced Refractive Treatment) group (M Ellipse-APA+ M Sphere Zonel-APA+ M Sphere Zone2-APA) in 70 eyes and ESS group (M Ellipse+ Multizone M Sphere Zone l +Multizone M Sphere Zone2) in 72 eyes. Corneal ablation, vision and postoperative complications and refraction were analyzed. Results (1) spherical equivalent refractive (SEQ) changed 1D in cornea plane: ESB group cut cornea (13.32 + 1.42) μ m, ART group (7.66 + 1.10) μ m,and BSS group (12.27 ± 0.48) μ m. (2) follow-up visited 1 year, uncorrected visual acuity (UCVA)increased after LASIK, UCVA increased to preoperative best corrected visual acuity (BCVA) or more in postoperative 1 month, UCVA stabilized in 3 months, BCVA was not lost 2 or more lines of visual acuity on the letter chart; SEQ of three groups were within + 0.50D in postoperative 3 months. (3) postoperative glare rate: ESB group 2 eyes (2.7％), ART group 4 eyes (5.7％), ESS group 2 eyes (2.8％), and relieved after 6 months; topography analysis found no eccentric ablation; refractive regression rate after 3 months: ESB group 3 eyes (4.1％), ART group 3 eyes (4.3％), ESS group 2 eyes (2.7％). Conclusions Based on different refraction and corneal thickness, VISX S4 excimer laser automatically choose the different ablation patterns for ultra-high myopia with predictability, effectiveness,stability and security; which ART ablation pattern saves corneal tissue to benefit to ultra-high myopia refractive correction in ultra-thin cornea, but the visual quality is questionable. Key words: Laser in situ keratomileusis; Myopia; Ultra-high; Ablation pattern

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