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Seven-year Follow-up of LASIK for Myopia
J Refract Surg. 2009;25:312-318.
Waldir Neira Zalentein, MD; Timo M.T. Tervo, MD and Juha M. Holopainen, MD
PURPOSE
To assess the long-term refractive results, subjective parameters, and late sequelae of LASIK.
METHODS
A retrospective follow-up study was conducted on 38 eyes of 21 patients (17 with bilateral treatment and 4 with unilateral treatment) who had LASIK surgery between 1999 and 2000. Laser ablations were done with an excimer laser (VISX Star and Star S2). Follow-up was 2 months, 2 years, and >7 years postoperatively. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, indirect ophthalmoscopy, and wavefront analysis were measured at the last follow-up and a questionnaire was answered.
RESULTS
Postoperatively, BSCVA ≤0.0 (logMAR) was obtained in 91%, 100%, and 89% of eyes at 2 months, 2 years, and at last follow-up, respectively. Postoperative spherical equivalent refraction within ±0.50 diopters (D) was obtained in 75%, 63%, and 42% of eyes at 2 months, 2 years, and 7 to 8 years, respectively. At 2 months and 2 years, 83% of eyes were within ±1.00 D, which decreased to 42% at 7 to 8 years. Mean spherical equivalent refraction at 2 months was –0.41 D, at 2 years –0.57 D, and at 7 to 8 years continued to decrease to –1.38 D. Patient satisfaction was high—100% of patients would have LASIK again.
CONCLUSIONS
LASIK outcomes tend to shift toward undercorrection over time. Postoperative ectasia was not noted 7 to 8 years after LASIK. All patients were satisfied with the postoperative results although emmetropia was not reached.
From the full text:
Currently, 4 studies with a combined total of 206 eyes have been published on postoperative LASIK results for myopia with follow-up >5 years...
In the present study, 63% of eyes were within +/-0.50 D and 83% were within +/-1.00 D of the intended correction at 2 years. This is consistent with the results of O’Doherty et al at 5 years. However, at last follow-up 7 to 8 years postoperatively, 34% of eyes were within +/-0.50 D and 42% were within +/-1.00 D. Similar to earlier results, myopic regression of the spherical equivalent refraction was noted. At 2 months, an undercorrection of -0.41 D was found; at 2-year follow-up, a minimal myopic regression to -0.57 D was noted, which continued to regress to -1.38 D at last followup. This trend toward myopic regression was noted in all 38 eyes, but it was more pronounced in eyes with preoperative spherical equivalent refraction >6.00 D and in patients aged <30 years. These results show that although refractive results after LASIK are relatively good in the short term, they tend to decline over time.
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Broken Eyes
"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato
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