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Minimum age for LASIK may be reduced in some low myopes, study finds
J Refract Surg. 2009;25:747-751.
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The minimum age at which some low myopes may undergo LASIK may be reduced from 20 years to 18 years because refractive error is not likely to progress, according to a study.
"The population results of this study suggest that the lower age boundary for LASIK could be reduced to 18 years for patients with less than 1 D of myopia at age 10 and less than 3 D of myopia at the time of surgery," the study author said. "This age reduction is due to the stabilization of refraction in this subset of patients."
The retrospective study included 77,124 eyes of 46,384 patients in Jordan examined for correlations between axial length, degree of corneal power and age.
Patients were assigned to one of four groups: emmetropia, hyperopia, low to moderate myopia and high myopia of more than 6 D. The prevalence of myopia was 23.8%, the prevalence of high myopia was 3.8%, and the prevalence of hyperopia was 17.5%. Patient age ranged from 3 years to 82 years, and refractive error ranged from +8 D to –22 D.
Patients with less than 1 D of myopia at age 10 years and less than 3 D of myopia at the time of refractive surgery had stable refraction at age 18 years that was not likely to progress; 7.4% of high myopes showed a progression of corneal power and axial length that remained unstable until age 30 years.
In patients with more than 3.25 D of myopia at age 10 years, the level of refractive error rose until age 30 years in 0.6% of patients with moderate myopia and 0.9% of patients with high myopia.
Patients with greater axial length in conjunction with higher corneal powers faced a significant risk of refractive error progressing after LASIK surgery.
The refractive error in hyperopic patients seemed to progress from age 30 years to 50 years, the study said.
Dr. Sayegh’s study points out statistically what we have generally known about laser vision correction (LVC) and long-term stability of refraction. In summary, patients with greater than 6 D of myopia and all degrees of hyperopia have a higher incidence of progression of refractive errors following LVC due to inherently less stable refractions relative to low myopes. Further, there was a 7.4% incidence of even greater refractive instability and progressive myopia in patients with myopia exceeding 6 D when combined with axial lengths greater than 26 mm. It was posited that these patients may also have a higher incidence of post-laser vision correction ectasia, and these patients should be so counseled prior to undergoing laser vision correction.
– Richard J. Duffey, MD
OSN Refractive
Surgery Board Member