Abstract
Abstract: :
Purpose: To determine the effect of Acular and other variables on the resolution of overcorrection resulting from treatment of myopia and compound myopic astigmatism by laser in situ keratomileusis. Method: Seventy-two eyes of 51 patients, with a mean age of 46 yrs (range 22-59 yrs) were analyzed. Thirty seven overcorrected eyes were randomly treated with Acular and 35 eyes were simply observed. Mean treatment time with Acular was 27 days (range 10-63 days). Pre and postoperative characteristics and refractions were compared between the two groups. Preoperative variables included age, eye, preoperative manifest and cycloplegic refractions, and pachymetry. Postoperative variables included presence of microstriae, and treatment with Acular. Success was measured by improvement of overcorrection by less than zero to .25 D, .50 D, .75 D, 1.00 D, and 1.25 D or more, at 1 month and 2 months postoperatively. All variables were analyzed by logistic regression analysis for outcome of success. Results: The Acular treated and non treated groups were matched for all preoperative variables including manifest and cycloplegic refraction, eye treated, and pachymetry, except for age which was on average 9 years older in the non treated group. (p=0.004). Postoperative mean spherical equivalent at was significantly higher at day 1 in the Acular treated group (p=0.02). This was not significant at the 1 month and 2 month periods. Preoperative pachymetry showed significance for success (p=0.05), with thicker corneas having improvement of +0.75 to +1.00 diopters of overcorrection. Preoperative difference between cycloplegic and manifest refractions was not associated with amount of postoperative overcorrection or the lack of improvement. Postoperative microstriae was not associated with lack of success over time. Conclusion: Acular does not improve postoperative overcorrection of eyes treated for myopic and compound myopic astigmatism when compared to a matched control group. Thicker corneas show greater improvement over time regardless of treatment. Microstriae are not associated with persistence of overcorrection.
Keywords: 548 refractive surgery: LASIK • 545 refractive surgery: complications • 390 drug toxicity/drug effects