Femtosecond-assisted laser in situ keratomileusis for high myopia correction: Long-term follow-up outcomes.

Abstract

Objective: Report the outcomes of laser in situ keratomileusis (LASIK) for high myopia correction after long-term follow-up. Methods: Retrospective, consecutive, clinical study including 70 eyes that underwent LASIK using a 500 Hertz (Hz) repetition rate excimer laser and femtosecond technology for flap creation. Visual, refractive, corneal aberrations, and correlation among the variables were evaluated during 3 years. In addition, 34 eyes were followed during 5 years. Results: Significant improvement of 17 logMAR lines was observed in uncorrected vision at 5 years (p < 0.01). This was consistent with spherical equivalent reduction that came from mean preoperative –7.79 diopters (D) to 5 years postoperative –0.24 D (p < 0.01). Significant induction of primary spherical aberration and coma aberration was also found (p < 0.01) at 3 months with levels of 0.61 µm and 0.47 µm, respectively, with no further changes at 5 years (p > 0.05). Pearson correlation showed that the amount of high-order aberrations at 3 months postoperativeley was significantly correlated with the changes in the keratometry throughout the 5 years (delta K) (R2 0.242 p = 0.05). Finally, preoperative corneal asphericity showed an inverse correlation with the delta K (R2 –308 p = 0.01). Conclusions: Results from this study suggests that LASIK for high myopia correction using 500 Hz repetition rate excimer laser provides stable visual, refractive and aberrometric results after 5 years of follow-up. A more prolate cornea and the amount of higher-order aberrations induced after LASIK are factors that negatively impact in the long-term stability of the procedure.