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Limits of LASIK in high myopia need to be clearly defined, surgeon says
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ROME — LASIK is a simple, safe and effective way to correct myopia, but it should not be performed in eyes higher than –8 D if prime results are to be obtained, according to a surgeon here.
"The limits of LASIK for myopia have been extensively discussed, but no clear conclusion has been found," Antonio Marinho, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons.
He recommended not operating on eyes with a spherical equivalent higher than –8 D.
"Highly myopic eyes have an immediate good refractive outcome, but over the years, regression occurs. Interestingly, the large optical zone that we use nowadays with the new lasers seems to lead to even more regression," Dr. Marinho said.
He also said that quality of vision may not be ideal in these eyes, despite new wavefront technology.
Some corneal or pupil conditions could also dissuade physicians from performing LASIK.
"If patients don't meet the safety parameters for corneal thickness (at least 500 µm), residual stromal bed (250 µm), corneal curvature (final keratometry readings of at least 34 D) and for pupil size (the optical zone should never exceed the mesopic pupil), results are going to be poor quality of vision, glare and halos and, possibly, ectasia," Dr. Marinho said.
A reversible type of refractive surgery, such as phakic or pseudophakic IOLs, is strongly recommended in these cases, he said.