Abstract
BackgroundTo evaluate laser-assisted in situ keratomileusis (LASIK) outcomes, subjective quality of vision (QoV) and patient satisfaction in eyes with very high myopia (VHM) above − 10.00 diopters (D).MethodsConsecutive myopic and myopic-astigmatism eyes with spherical equivalent (SEQ) ranging between − 10.00 to − 13.50 D underwent LASIK with the WaveLight® Allegretto Wave® Eye-Q 400 Hz excimer laser. Treatment accuracy, efficacy, safety, stability, cylinder vectors, and higher-order aberrations were evaluated, together with subjective QoV and night vision disturbances (NVDs).Results114 eyes had a preoperative SEQ of − 11.02 ± 0.81 D, with a median follow-up of 24 months. A total of 72, 84, and 94% of eyes were within ± 0.50, ± 0.75 and ± 1.00 D of intended SEQ (R2 = 0.71). The efficacy index was 0.93 ± 0.20, with 51 and 81% of eyes achieving 20/20 and 20/25. The astigmatism correction index was 0.95 ± 0.33. The safety index was 1.05 ± 0.12. The average myopic regression was − 0.51 ± 0.38 D. Preoperative QoV scores improved significantly postoperatively (7.5 ± 0.8 vs. 9.1 ± 0.7; P < 0.001), with less NVDs (P < 0.001). Total, spherical and coma root mean square (RMS) postoperative ocular higher-order aberrations were 1.07 ± 0.34, 0.67 ± 0.25, and 0.70 ± 0.40 μm.ConclusionsVery high myopia LASIK between − 10.00 to − 13.50 D is safe and results in good visual outcomes, with high patient satisfaction and a significant improvement in patient-reported QoV after surgery. Appropriately selected patients within this very high myopia group can be included as LASIK candidates.
Highlights
To evaluate laser-assisted in situ keratomileusis (LASIK) outcomes, subjective quality of vision (QoV) and patient satisfaction in eyes with very high myopia (VHM) above − 10.00 diopters (D)
Newer, advanced laser platforms can be used for high myopic correction, but the Wallerstein et al BMC Ophthalmology (2020) 20:234 effectiveness and safety profile has not been adequately characterized in very high myopia (VHM) eyes with spherical equivalent (SEQ) exclusively above − 10.00 D, with a limited number of eyes in the literature
This study reports on postoperative ocular higher-order aberrations with patient-reported subjective QoV and satisfaction
Summary
To evaluate laser-assisted in situ keratomileusis (LASIK) outcomes, subjective quality of vision (QoV) and patient satisfaction in eyes with very high myopia (VHM) above − 10.00 diopters (D). Many surgeons are apprehensive in performing laserassisted in situ keratomileusis (LASIK) in patients with very high levels of myopia, greater than − 10.00 diopters (D), due to concerns regarding outcomes and safety. Many of these concerns originate from older generation. This study undertook a detailed outcomes analysis of a large sample of LASIK eyes with VHM from − 10.00 to − 13.50 D using a fast repetition scanning small spot excimer laser. This study reports on postoperative ocular higher-order aberrations with patient-reported subjective QoV and satisfaction
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