Three-Year Follow-Up of Laser In Situ Keratomileusis Treatments for Myopia: Multi-Center Cohort Study in Korean Population

Abstract

This multi-center cohort study included 3401 myopic laser in situ keratomileusis (LASIK) procedures conducted in 1756 myopia patients between 2002 and 2005. Pre- and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and manifest refraction spherical equivalent (SE) were recorded. Factors predicting low postoperative efficacy (defined as a postoperative UCVA < 0.5) were identified using univariate and multivariate logistic regression analysis. Compared with 1 month postoperatively, logMAR UCVA at 3 months postoperatively was significantly decreased (p = 0.002) and that at 2 and 3 years was significantly increased (p < 0.001). LogMAR BCVA at 2 years postoperatively was significantly decreased compared with 1 month postoperatively (p = 0.008). Over the 3-year postoperative period, overall refractive predictability within ±1.00 D and ±0.50 D ranged from 69.0% to 86.2% and from 43.3% to 67.8%, respectively. This also decreased from 1 month to 6 months postoperatively (p < 0.005). Multivariate logistic regression analysis using generalized estimating equations, revealed that higher preoperative SE (odds ratio [OR], 2.58 and 7.23; p < 0.001) and lower preoperative BCVA (OR, 2.44; p = 0.003) were predictive of a low postoperative efficacy. In summary, myopic LASIK can be effective and safe with a high refractive predictability in a Korean population, but myopic regression occurs over time. Higher preoperative SE and lower preoperative BCVA are predictive of a low postoperative efficacy.

Long-Term Results of Laser In Situ Keratomileusis in Myopic Patients with Topographic Indices outside Suggested Ranges

“…Based on the results of the present study, 79.90% of eyes achieved ± 0.50 D and 92.40% of eyes achieved ± 1.00 D of the target refraction. These results are similar to previous studies in normal populations where the authors reported that 67.80–74.80% of the eyes achieved ± 0.50 D of target refraction and 76.20–97.60% of the eyes achieved ± 1.00 D of target refraction [ 12 , 20 , 21 ]. It can be concluded that patients with topographic indices slightly over the suggested range experienced good refractive changes after LASIK.…”

Posterior chamber toric implantable collamer lenses vs LASIK for myopia and astigmatism: systematic review

“…26 A 3-year follow-up multicenter cohort study on LASIK in the Korean population (n = 3401) reported 8.8% undercorrection and 0.6% overcorrection 1 month after LASIK with an enhancement rate of 0.7%. 5 In our opinion, the high rate of undercorrection could be due to the early postoperative time frame because epithelial remodeling after LASIK surgery takes up to 3 months. A 5-year observational case series on LASIK for myopia <−12 D (n = 779) reported roughly similar results regarding undercorrection (4.8%) and overcorrection (0.5%); however, they mentioned a higher enhancement rate of 17.5%, of which 11.9% was retreated because of myopic regression with decreased UDVA over time.…”

“…[37][38][39] On the other hand, publications on postoperative complications and adverse effects after LASIK surgery consisted of epithelial ingrowth (0.1% and 2.7%), dry eye disease (1.1%), post-LASIK keratectasia (0%), infectious keratitis (0.1%), diffuse lamellar keratitis (DLK) (2.1%), and corneal opacification (among which DLK) (0.9%). 5,32 Of interest, 1 follow-up study of 12 years (n = 68) reported a zero incidence of postoperative complications (epithelial ingrowth, DLK, severe dry eye, and keratectasia). 4 The limitations of our review go back to the large diversity of included study designs, resulting in the inclusion of papers with variable value of evidence and quality.…”

“…Laser in situ keratomileusis (LASIK) has been proven to be safe and effective in the treatment of myopia. [3][4][5] Among its advantages are the superficial nature of the treatment and faster visual recovery compared with surface ablation techniques (photorefractive keratectomy and laser-assisted subepithelial keratectomy). 6,7 However, the risk for postoperative keratectasia increases with the amount of ablated stromal tissue, making it less suitable for patients with higher myopia or thin cornea.…”

Long-term results of laser in situ keratomileusis for myopia

“…Kim et al stated in their study that LASIK may be safe and effective on a large myopic population, but over time myopic regression occurs. Lower preoperative best corrected visual acuity and higher preoperative SE can predict low postoperative efficacy [16]. Ikeda et al reported that LASIK offered good safety outcomes in highly myopic eyes during their 12-year observation period, however the predictability and efficacy gradually decreased with time because of myopic regression [11].…”