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Study shows steady improvements in myopic LASIK in Asian eyes over 10-year period

Ophthalmology. 2010;117(6):1236-1244.

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Myopic LASIK is safe, effective and predictable in Asian eyes, according to results of a large 10-year clinical audit.

"Myopic LASIK performed in Asian eyes within a comprehensive LASIK clinical program with appropriate clinical audit governance can be safe and effective, with high refractive predictability," the study authors said. "Improvements in the nomograms to prevent undercorrection and to compensate for myopic regression have led to better efficacy after LASIK, with an increasing percentage of patients achieving 20/15 visual acuity postoperatively."

The prospective study included 37,932 eyes of 19,753 patients who underwent myopic LASIK performed by multiple surgeons at one center in Singapore between 1998 and 2007. Mean patient age was 33 years. Most patients were of ethnic Chinese descent (90.5%). Mean postoperative follow-up was 68.8 days.

Investigators recorded preoperative and postoperative refraction, uncorrected visual acuity and best corrected visual acuity.

Primary outcome measures were safety, efficacy, refractive probability, treatment trends, re-treatment rates and complications. The benchmarks for mild, moderate and high myopia were spherical equivalent of less than –5 D, –5 D or more to less than –10 D, and –10 D or more, respectively.

Mean spherical error corrected was –5.9 D.

Study data showed that UCVA of 20/40 or better has held consistently at higher than 90% since 2000; 72.8% of eyes achieved UCVA of 20/20 or better. In addition, refractive correction was within 1 D of the target value in more than 93% of eyes in the final 4 years of the study.

Results showed that safety improved steadily since the beginning of the study. The best outcomes were achieved in 2007, with 2.4% of eyes losing one Snellen line of BCVA and 0.1% losing two lines, the authors reported,

The overall re-treatment rate was 3.8%, with 91% of re-treated eyes achieving UCVA of 20/30 or better.

Improvements in postoperative UCVA and BCVA over the 10-year period were statistically significant (P < .001), the authors said.

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