Abstract
Abstract: :
Purpose: To analyze cases with epithelial defects (ED) occurring at the time of primary LASIK and identify predictive preoperative risk factors. Methods: Retrospective review of all LASIK cases performed from January 1, 2001through May 10, 2002. Preoperative variables analyzed included patient age, gender, and preoperative refraction. Age-matched populations with hyperopic and myopic preoperative refractions were also compared. Results: There were a total of 7014 primary LASIK cases, including 6067 cases with myopic preoperative refractions (myopes) and 947 with hyperopic preoperative refractions (hyperopes). Overall, 651 (9.3%) cases had intraoperative epithelial defects. There were 329 (9.62%) cases with ED occurring in males and 322 (8.98%) cases with ED occurring in females (p=0.365). Epithelial defect rate increased proportionately with patient age, with 149 (5%) cases in patients less than 40 years and 502 (13.4%) cases in patients greater than 40 years (p<0.001). There were 164 (17.3%) cases of ED in hyperopes and 487 (8.03%) cases with ED in myopes (p<0.001). We further analyzed an age-matched subset of 1722 cases, including 861 hyperopic eyes and 861 myopic eyes, with an average age of 49.9 years. There were again no significant differences in ED rate by gender. In this age-matched population, there were 159 (18.46%) cases with ED in hyperopes and 104 (12.1%) cases with ED in myopes (p<0.001). Conclusions: Intraoperative epithelial defects occurred in 9.3% of primary LASIK cases. Risk factors for epithelial defects included patient age greater than 40 and preoperative hyperopia, which remained a significant risk factor even when controlling for age. Neither male or female gender was associated with a significantly higher epithelial defect rate.
Keywords: refractive surgery: complications • cornea: epithelium