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MD Bailey, G Mitchell, K Zadnik; Risk Factors For Subjective Visual Symptoms After Laser In Situ Keratomileusis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4144.
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Purpose: To examine preoperative risk factors for decreased satisfaction and symptoms of glare, halos, and/or starbursts after laser in situ keratomileusis (LASIK). Methods: Questionnaires, using visual analog scales to assess symptoms and satisfaction after LASIK, were mailed to 2100 patients from the Northeastern Eye Institute, UCLA, and the University of Pittsburgh. All subjects completed the questionnaire at least 6 months after having LASIK. Preoperative corneal and refractive parameters were collected from the medical charts of subjects who returned the questionnaire and compared to subject questionnaire responses. Results: The return rate for the questionnaire was 42.8%. The mean age for all subjects was 43.0 ± 10.6 years. Sixty-three percent of the subjects were women. Overall, 97% of the subjects would recommend LASIK to a friend. However, a significantly larger percentage of subjects who reported that they would not recommend LASIK to a friend, experienced glare, halos, or starbursts (81.3% vs. 53.1%, p=0.03). Also, subjects with flatter preoperative minimum corneal curvature values were 29% more likely to report that they would not recommend LASIK to a friend (p=0.02, 95% confidence interval (CI) =0.94, 0.52). The average subject satisfaction was rated at 87.2% of the maximal value. However, older subjects were more likely to report that they were not satisfied with their vision after LASIK (OR= 1.71, p=0.02, 95% CI =1.10, 2.56). Halos were reported by 30%, glare by 27%, and starbursts by 25% of all subjects. Subjects who reported starbursts had a significantly flatter preoperative minimum corneal curvature (43.54 ± 1.60 D versus 43.91 ± 1.70 D, p=0.03). Also, subjects who had surgical enhancement were more likely to experience glare, halos, and/or starbursts (OR=2.14, p=0.002, 95% CI =1.33, 3.46). Conclusion: Most subjects are satisfied with their vision after LASIK. However, decreased satisfaction after LASIK is associated with postoperative symptoms of glare, halos and starbursts. Increasing age and flatter preoperative minimum corneal curvature were risk factors for decreased satisfaction after LASIK. The presence of starbursts after LASIK is associated with flatter preoperative corneal curvature. Enhancement after LASIK is a risk factor for experiencing night vision symptoms.
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