Predictors affecting myopic regression in − 6.0D to − 10.0D myopia after laser-assisted subepithelial keratomileusis and laser in situ keratomileusis flap creation with femtosecond laser-assisted or mechanical microkeratome-assisted

Abstract Purpose To investigate the predictive factors of postoperative myopic regression among subjects who have undergone laser-assisted subepithelial keratomileusis (LASEK), laser-assisted in situ keratomileusis (LASIK) flap created with a mechanical microkeratome (MM), and LASIK flap created with a femtosecond laser (FS). All recruited patients had a manifest spherical equivalence (SE) from − 6.0D to − 10.0D myopia. Methods This retrospective, observational case series study analyzed outcomes of refraction at 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Predictors affecting myopic regression and other covariates were estimated with the Cox proportional hazards model for the three types of surgeries. Results The study enrolled 496 eyes in the LASEK group, 1054 eyes in the FS-LASIK group, and 910 eyes in the MM-LASIK group. At 12 months, from − 6.0D to − 10.0D myopia showed that the survival rates (no myopic regression) were 52.19%, 59.12%, and 58.79% in the MM-LASIK, FS-LASIK, and LASEK groups, respectively. Risk factors for myopic regression included thicker postoperative central corneal thickness (P ≦ 0.01), older age (P ≦ 0.01), aspherical ablation (P = 0.02), and larger transitional zone (TZ) (P = 0.03). Steeper corneal curvature (Kmax) (P = 0.01), thicker preoperative central corneal thickness (P < 0.01), smaller preoperative myopia (P < 0.01), longer duration of myopia (P = 0.02), with contact lens (P < 0.01), and larger optical zone (OZ) (P = 0.02) were protective factors. Among the three groups, the MM-LASIK had the highest risk of postoperative myopic regression (P < 0.01). Conclusions The MM-LASIK group experienced the highest myopic regression, followed by the FS-LASIK and LASEK groups. Older age, aspheric ablation used, thicker postoperative central corneal thickness, and enlarging TZ contribute to myopic regression; steeper preoperative corneal curvature (Kmax), longer duration of myopia, with contact lens, thicker preoperative central corneal thickness, lower manifest refraction SE, and enlarging OZ prevent postoperative myopic regression in myopia from − 6.0D to − 10.0D.

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Measurement of Central Corneal Thickness With Optical Low-Coherence Reflectometry and Ultrasound Pachymetry in Normal and Post-Femtosecond Laser in Situ Keratomileusis Eyes

Cornea ◽

10.1097/ico.0000000000000329 ◽

2015 ◽

Vol 34 (2) ◽

pp. 204-208 ◽

Cited By ~ 4

Author(s):

Jinhai Huang ◽

Na Liao ◽

Giacomo Savini ◽

Yuanguang Li ◽

Fangjun Bao ◽

...

Keyword(s):

Femtosecond Laser ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Laser In Situ Keratomileusis ◽

Low Coherence ◽

Ultrasound Pachymetry ◽

Optical Low Coherence Reflectometry

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Long-term evaluation of eyes with central corneal thickness <400 µm following laser in situ keratomileusis

Clinical Ophthalmology ◽

10.2147/opth.s100690 ◽

2016 ◽

pp. 535 ◽

Cited By ~ 2

Author(s):

Mohammad Reza Djodeyre ◽

Jaime Beltran ◽

Julio Ortega-Usobiaga ◽

Felix Gonzalez-Lopez ◽

Ana Ruiz-Rizaldos ◽

...

Keyword(s):

Central Corneal Thickness ◽

Corneal Thickness ◽

Laser In Situ Keratomileusis ◽

Term Evaluation

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Correlation of intraocular pressure and central corneal thickness in normal myopic eyes and after laser in situ keratomileusis

Journal of Cataract & Refractive Surgery ◽

10.1016/s0886-3350(98)80222-8 ◽

1998 ◽

Vol 24 (10) ◽

pp. 1320-1325 ◽

Cited By ~ 88

Author(s):

Barry Emara ◽

Louis E. Probst ◽

David P. Tingey ◽

Dennis W. Kennedy ◽

Lisa J. Willms ◽

...

Keyword(s):

Intraocular Pressure ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Laser In Situ Keratomileusis

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Twelve-Year Follow-Up of Laser In Situ Keratomileusis for Moderate to High Myopia

BioMed Research International ◽

10.1155/2017/9391436 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Tetsuya Ikeda ◽

Kimiya Shimizu ◽

Akihito Igarashi ◽

Sumie Kasahara ◽

Kazutaka Kamiya

Keyword(s):

High Myopia ◽

Central Corneal Thickness ◽

Pearson Correlation ◽

Corneal Thickness ◽

Laser In Situ Keratomileusis ◽

Manifest Refraction ◽

Observation Period

Purpose. To assess the long-term clinical outcomes of conventional laser in situ keratomileusis (LASIK) for moderate to high myopia.Methods. We retrospectively examined sixty-eight eyes of 37 consecutive patients who underwent conventional LASIK for the correction of myopia (−3.00 to −12.75 diopters (D)). At 3 months and 1, 4, 8, and 12 years postoperatively, we assessed the safety, efficacy, predictability, stability, mean keratometry, central corneal thickness, and adverse events.Results. The safety and efficacy indices were0.82±0.29and0.67±0.37, respectively, 12 years postoperatively. At 12 years, 53% and 75% of the eyes were within 0.5 and 1.0 D, respectively, of the targeted correction. Manifest refraction changes of −0.74±0.99 D occurred from 3 months to 12 years after LASIK (p<0.001). We found a significant correlation of refractive regression with the changes in keratometric readings from 3 months to 12 years postoperatively (Pearson correlation coefficient,r=-0.28,p=0.02), but not with the changes in central corneal thickness (r=-0.08,p=0.63). No vision-threatening complications occurred in any case.Conclusions. Conventional LASIK offered good safety outcomes during the 12-year observation period. However, the efficacy and the predictability gradually decreased with time owing to myopic regression in relation to corneal steepening.

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Stability of corneal topography and aberrometry after hyperopic laser in situ keratomileusis with a 500-Hz excimer laser platform: A 3-year follow-up study

European Journal of Ophthalmology ◽

10.1177/1120672119875358 ◽

2019 ◽

Vol 30 (6) ◽

pp. 1238-1245

Author(s):

Ana B Plaza-Puche ◽

Verónica Vargas ◽

Pilar Yébana ◽

Samuel Arba ◽

Jorge L Alio

Keyword(s):

Excimer Laser ◽

Spherical Aberration ◽

Case Series ◽

Corneal Topography ◽

Laser In Situ Keratomileusis ◽

Case Series Study ◽

Significant Difference ◽

Optical Zone

Purpose: The aim of this study is to analyze the long-term stability of the corneal topography, the functional optical zone, and the refractive stability throughout 3 years following laser in situ keratomileusis surgery for hyperopia using a 500-Hz excimer laser system. Methods: This retrospective consecutive observational case series study comprised 66 eyes that underwent laser in situ keratomileusis to correct hyperopia with a postoperative follow-up of 3 years. Laser in situ keratomileusis procedures were performed using the SCHWIND Amaris 500-Hz excimer laser. Main outcomes measured were stability of the functional optical zone at corneal topography and corneal aberrometry. Results: Statistically significant differences were found in simulated keratometry (K2 (steep meridian) and Km (mean keratometry)) between 3 and 36 months postoperatively ( p ⩽ 0.01); these differences disappeared at 12 and 36 months ( p ⩾ 0.18). No statistically significant changes were observed in the horizontal and vertical diameter of the functional optical zone throughout the whole follow-up ( p ⩾ 0.07). A statistically significant difference was found in the spherical aberration between 3 and 36 months ( p = 0.02); this difference disappeared when compared between 12 and 36 months ( p = 0.72). Statistically significant correlations were detected between the vertical functional optical zone and coma root mean square ( r = –0.510, p < 0.01) and between the vertical functional optical zone and spherical aberration ( r = 0.441, p = 0.02) 36 months after surgery. Conclusion: Following 3 years of hyperopic laser in situ keratomileusis with a 500-Hz Amaris excimer laser, keratometry, functional optical zone, and corneal aberrations remain stable from 1 year after surgery. Topographical regression is not observed in hyperopic laser in situ keratomileusis with this excimer laser technology from 1 year after surgery.

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