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Kelly Krespan, Jay M Lustbader; Outcomes in myopic LASIK and PRK. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5750. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Although LASIK and PRK have been shown to be safe and effective in high myopia in both the short and long-term, surgeons still debate which technique will provide the best outcomes for their patients. We assessed visual acuity outcomes in low to moderate myopes and high myopes who underwent LASIK and PRK in a retrospective, observational study.
Charts were reviewed for patients who underwent a first treatment of myopic LASIK or PRK by a single surgeon at a quaternary care center between February 1, 2012 and January 31, 2017. High myopia was defined as ≥ 6.0D. All patients had ≤2.0D. All LASIK flaps were created with the Johnson and Johnson Intralase femtosecond laser. All treatments were performed with the Alcon Wavelight Alegretto Wave Eye-Q excimer laser. Patients were selected for PRK over LASIK for thinner corneal thickness or more irregular topography. Preoperative demographics, as well corrected and uncorrected visual acuity were collected. LASIK was performed on 1,949 low myopic eyes, and 356 highly myopic eyes. PRK was performed on 590 low myopic eyes, and 177 highly myopic eyes. Postoperative 1 month and 3 month data were collected for uncorrected distance visual acuity. Data was analyzed in the Zubisoft ibra database software.
Postoperative uncorrected distance visual acuity (UCDVA) was statistically significantly worse in highly myopic eyes compared to less myopic eyes treated with LASIK (p <0.0001 at 1 and 3 months). In eyes treated with PRK, UCDVA at 3 months was not different in high myopes or lower myopes.(p<0.0001 at 1 month, p<0.0006 at 3 months). Comparing LASIK to PRK, both low and high myopes had statistically significantly better acuity at 1 month when treated with LASIK (p<0.0001 for low myopes, p<0.0004 for high myopes). At 3 months this difference disappeared. In all groups, UCDVA was 20/25 or better.
Low to moderate myopes treated with LASIK or PRK had statistically significantly better mean UCVA at 1 and 3 months compared to high myopes. However, in both groups mean UCVA was excellent (better than 20/25). Outcomes in low to moderate myopes and high myopes were different at 1 month but not different at 3 months when comparing eyes treated with LASIK and PRK. This likely reflects healing times.This was a limited retrospective study, and an expanded prospective study could investigate a variety of outcomes, as well as identify risk factors for outliers of these overall very successful techniques.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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