Ten-year follow-up on LASIK for high myopia reported

Results of 10-year follow-up of patients with high myopia who underwent LASIK indicate that the procedure is safe and effective over the long term, said Juan J. Perez-Santonja, MD, Alicante Institute of Ophthalmology, Miguel Hernandez University, Alicante, Spain. In his study, 40% of eyes avoided use of spectacles, best spectacle-corrected visual acuity (BSCVA) improved 1 line, and complications were infrequent.

However, predictability was low, there was a high chance of re-treatment, and refraction was never stable over the 10-year period. Dr. Perez-Santonja said. Thus, the data do not support LASIK as a first-choice procedure for patients with myopia of more than –10 D, he added.

Dr. Perez-Santonja reported the outcomes of surgery in 196 eyes (118 patients) with a spherical equivalent of more than –10 D who had myopic LASIK between April 1994 and December 1995. They had follow-up visits at 3 months, 1 year, 3 years, 5 years, and 10 years; 54 eyes (27%) were re-treated.

Significant improvement in distance uncorrected and best-corrected visual acuity was seen between 3 months and 1 year in three categories: re-treated eyes, eyes with no re-treatment, and all eyes. Vision remained stable up to at least 5 years. The percentage of eyes with uncorrected visual acuity 20/40 or better was 50% at 1 year and 51% at 5 years, but it declined to 39% at 10 years.

Mean BSCVA improved 1 line after surgery. Fifteen eyes (7.6%) lost 2 or more lines of visual acuity in 10 years, although the loss was attributable to complications from LASIK rather than from high myopia in only 3 eyes, Dr. Perez-Santonja said.

The spherical equivalent improved postoperatively for all time points; however, there was also a continuous decrease over time, especially in eyes that were not re-treated. Myopic regression was 1 D in the first year, 0.5 D in the second year, 0.18 D per year between the second and fifth year, and 0.15 D per year between the fifth and the tenth year.

"If we add all of these results together, we have 2.5 D of regression over time after LASIK," Dr. Perez-Santonja said. The regression correlated with the magnitude of achieved correction.