Abstract
Aim:To evaluate the predictive factors of LASIK procedure for high myopia with or without astigmatism using a combination of high-frequency femtosecond-assisted LASIK followed by an excimer laser.Methods:This study was a retrospective interventional case series study to evaluate myopic eyes undergoing high platform LASIK with FEMTO LDV Z2 intervention, followed by WaveLight®EX500 excimer laser machine. Subjects were divided into 2 groups: high myopia (SE of -6.01 to -9.00 D) and very high myopia (SE of -9.01 D or higher). Myopic eyes (Spherical Equivalent/SE) less than –13 D were included in this study. Visual Acuity (VA) was evaluated 1 day and 60 days after the procedure. Predictive factors, such as age, degree of sphere, degree of astigmatism, keratometric reading and axial length were analyzed to detect any influences affecting the final VA results.Results:A total of 316 myopia eyes underwent intervention, mean age: 25.3±3.8 years. Target treatment was achieved in 96.1% of patients with high myopia and 69.9% of patients with very high myopia. High degree of sphere and astigmatism constitutes an important factor influencing final VA.Conclusion:Modern machines provide a more promising efficacy and success of LASIK procedure in high myopia: important predictive factors were a high degree of sphere and astigmatism for achieving the optimal final outcome.
Highlights
Advanced development of Laser-in-situ Keratomileusis (LASIK) is a state-of-the-art technology in refractive surgery, especially for myopia treatment ≤ -13D and astigmatism ≤ -5.00 D [1 - 4]
LASIK procedure was performed for both eyes in 316 subjects, we included in this study one eye with high myopia found in 217 (64.2%) eyes and very high myopia demonstrated in 99 (35.8%) eyes
Male Female Age, years [median] a Degree of myopia b High myopia Very high Mean corneal thickness μm (x±SD)b Steepening keratometric reading (D) Mean axial length, mm (x ± SD)b Within target Categorical data was reported as actual number (%)a and numerical data was presented as mean and Standard Deviation (SD)b
Summary
Advanced development of Laser-in-situ Keratomileusis (LASIK) is a state-of-the-art technology in refractive surgery, especially for myopia treatment ≤ -13D and astigmatism ≤ -5.00 D [1 - 4]. By using a much faster multifying spot system, a smaller laser spot with overlapping ablation and a higher repetition rate with the potential to track eye movement, the result was more favorable when compared to the use of lower platform LASIK machine [19 - 21]. No data is yet available to determine the outcome of LASIK treatment, especially in high and very high myopia cases in Indonesia. This is an important factor that necessitated resetting of our normogram to achieve an optimal final outcome. The aim of our study is to assess the related factors for successful LASIK procedure in terms of visual and refractive errors for myopic eyes ≥ -6.00 D to -13.0 D with or without astigmatism using LDV Z2 femtosecond laser, followed by WaveLight®EX500 excimer laser machine
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