Abstract

BackgroundTo evaluate corneal epithelial thickness change during medical treatment for eyes with myopic regression after femtosecond laser-assisted in situ keratomileusis (FS-LASIK).MethodsThis study included 84 eyes of 54 subjects diagnosed with myopic regression after FS-LASIK and treated using topical steroid and anti-glaucoma drugs. Corneal epithelial thickness was measured using Fourier-domain optical coherence tomography before and after treatment. Subjects were divided into three groups based on their corneal epithelial thickness at the time of myopic regression and regression analyses were used to investigate the association between corneal epithelial thickness, visual acuity, and refraction. Logistic regression and receiver operating characteristic (ROC) curve analysis was performed to determine whether corneal epithelial thickness could predict the success of treatment, improvements of ≥ two lines in uncorrected distance visual acuity and ≥ 0.5 diopter in refraction or K.ResultsCorneal epithelial thickness decreased with greater change in the center as myopic regression subsided during medical treatment. Subgroup with the thickest epithelium (≥ 62 μm) showed a higher success rate and greater changes in refraction and vision. Reduced magnitude of corneal epithelial thickness showed significant correlations with changes of K and refractive error (all P < 0.001). Corneal epithelial thickness was a significant factor for the success of treatment and ROC curve showed that corneal epithelial thickness > 60.50 μm had 81.5% sensitivity and 84.2% specificity for the success of medical treatment.ConclusionCorneal epithelial thickness decreases proportionally with the magnitude of improvement of myopic regression during treatment with steroid and anti-glaucoma drugs in post-LASIK eyes with myopic regression.

Highlights

  • To evaluate corneal epithelial thickness change during medical treatment for eyes with myopic regression after femtosecond laser-assisted in situ keratomileusis (FS-Laser-assisted in situ keratomileusis (LASIK))

  • The corneal epithelial thickness of treatment group decreased by 5.9 ± 3.6 μm during medical treatment, whereas that of untreated eye group showed no significant changes during follow-up

  • Patients with thicker corneal epithelium tended to show a greater change in corneal epithelial thickness as well as in refraction or in Uncorrected distance visual acuity (UDVA) leading to higher success rate (Table 3)

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Summary

Introduction

To evaluate corneal epithelial thickness change during medical treatment for eyes with myopic regression after femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Laser-assisted in situ keratomileusis (LASIK) is widely accepted as a reproducible and effective surgical procedure for correcting myopia. Studies have reported a relationship between the elevation of intraocular pressure (IOP) and corneal protrusion, and demonstrated that topical anti-glaucoma eye drops were effective in correcting approximately 0.5 diopter (D) of refractive regression. This was presumably a result of lowered IOP leading to the backward movement of the cornea and the flattening of its curvature [4,5,6,7]. Steroid eye drops have long been used to decrease myopic regression after photorefractive keratectomy (PRK), as myopic regression has been known to be related to wound healing [8, 9]

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