Effect of laser in situ keratomileusis on accommodation

Abstract

The accommodative function before and after laser in situ keratomileusis (LASIK) was observed, and the effect of LASIk on accommodation was investigated. In a prospective clinical trial, 48 myopic patients (96 eyes) subject to bilateral LASIK in Refractive Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (China) from March 2006 to June 2006 were selected and studied. Refractions, accommodative range, amplitude of accommodative response and high frequency component (HFC) of accommodative microfluctuations were measured with NEDIK-730A before and one week and 30 days after operation. Dominant and non-dominant eyes were determined by hole-in-card method. It was found that all of the operative eyes showed an uncorrected visual acuity of 0.8 or better one week postoperatively, and 1.0 or better 30 days postoperatively. Compared with those preoperatively, accommodative range and HFC had no significant difference at first week and 30th day after operation in both dominant eyes and non-dominant eyes (P>0.05), but there was a significant difference in the amplitude of accommodative response/accommodative stimulus ratio (A/S) after operation (P<0.01), and no significant difference was found in accommodation between one week and 30 days postoperation. No ocular dominance's change was noted. There was no significant difference in accommodative function between dominant eyes and non-dominant eyes. It was suggested that LASIK produced no significant effect on accommodation.

Changes in accommodative function following small-incision lenticule extraction for high myopia

“…In summary, none of the accommodative assessments performed in this study worsened following SMILE for high myopia; this result agrees with the relatively few other studies published on the topic [11][12][13]. The methodology in this study, however, was slightly different compared to those previous studies in that refraction errors in the present study were corrected with contact lenses to the greatest extent possible at both time visits, removing any influence from spectacles vs. contact lenses and any residual refraction on the assessments of accommodation.…”

“…Similarly, the push-up method used here did not correct for increasing image size as the target came closer-nonetheless, since the focus was on change and not absolute measurements, this should not affect the conclusions. To our knowledge, no other study has yet examined the amplitude of accommodation following SMILE; Liu et al [13] found no change in amplitude of accommodation following laser-assisted in situ keratomileusis for mild to moderate myopia (method used for measuring the amplitude of accommodation not reported), while Karimian et al [12] found a slight statistically significant increase of about 0.6 D for patients aged under 30 but no difference for patients aged above 30 following photorefractive keratectomy (PRK) using the minus-lens method. Given that Rosenfield et al [22] proposed that a clinically significant change of at least ±1.50 D should be adopted as a minimum significant shift in amplitude of accommodation, the change of 0.60 D for young patients found by Karimian et al [12] also seems negligible.…”

“…To date, only few studies have examined how parameters of the accommodative function change due to corneal refractive surgery [11][12][13]. To the best of our knowledge, only a study by Zheng et al [11] has evaluated accommodation in relation to SMILE for myopia; in their study, however, Zheng et al only examined the accommodative response and did not report how the refractive error was corrected during the tests.…”

Objective Accommodation Measurements by Using a New Autorefractometer Device

“…The effects of LASIK on AA have been investigated previously. Liu et al (23) stated that LASIK treatment did not have a significant effect on AA. Another study by Prakash et al (24) reported that the AC/A value after LASIK was stabilized between three months and nine months and it was a variable the first three months after LASIK.…”

Binocular vision alterations after refractive and cataract surgery: a review

“…Liu et al. () found no differences in terms of amplitude of accommodation after myopic LASIK, but the amplitude of accommodative response/accommodative stimulus (A/S) ratio did change postoperatively. Even some near vision‐related complaints were reported during the early post‐LASIK period, but as they were transient rather than permanent, they concluded that LASIK had no significant impact upon accommodation.…”