The Clinical Results After The Improved Flap-free Epi-LASIK In High And Super-high Myopia

Objective：This paper followed up some of patients, who used to be suffered fromlow to moderate myopia, high myopia and super-high myopia separately, to study theclinical effect of Improved Flap-free Epi-LASIK treatment. The uncorrected visualacuity, intraocular pressure(IOP),corneal irritation, Haze, corneal curvature and othersimilar parameters of them were compared. And the predictability, safety, effectivenessand stability of this treatment were also discussed.Methods: We selected120myopes (240eyes) who took Improved Flap-freeEpi-LASIK treatment in our hospital during May to December in2011. The selectedmyopes were divide into3group based on their myopia degree, including40low tomoderate myopia (≥-2.0D and <-6.0D)40high myopia (≥-6.0D and<-9.0D)and40super-high myopia (≥-9.0D<-14.0D). Those patients were followed up after treatmentfor one year and the early corneal irritation, corneal epithelial healing hours,uncorrected visual acuity, Haze, IOP, corneal curvature, and other related indexes ofthose patients were studied.Result:1.The difference of the early uncorrected visual acuity of all groups also arenot statistical significant (P>0.05).2.Compared with the low to moderate group, the differences of uncorrected visualacuity results of high myopia group observed at1,3,7and12months after treatmentare not statistical significant (P>0.05), while that of super-high myopia group reachesstatistical significance.3.By treatment, nearly all patients reached the standard of BCVA while only twoeyes in super-high myopia group did not (reached the goal of visual). Each group haveno statistical significance in the difference between the UCVA and the BCVA before surgery (P>0.05).4.The UCVA after surgery had statistical significant difference to the goal of visualin the super-high myopia group (P<0.05).The statistical significant difference is not inthe high myopia group (P>0.05).5.The BCVA after surgery had no statistically significant difference to the BCVAbefore surgery in the high myopia group and super-high myopia group (P>0.05).6.Each group have no statistical significance in Satety index or Effectiveindex(P>0.05).7. After operation treatments, the IOPs of each group were steady and their valueswere lower than those before treatments. The difference between each group was notstatistical significant（P>0.05）.8.The healing time of corneal epithelial don’t reach statistical significance(P>0.05).9.There is evident early corneal irritation observed in all groups. After treatmentthe differences of the high and super-high myopia have no statistical significant (P>0.05)compared to those of the low to moderate myopia.10.The incidence rates of Haze of all groups reached their maximum at3monthsafter treatment. Then they decreased gradually and were not higher than class2. At1,3,6and12months after treatment, the incidence rate of Haze of super-high myopia groupwas higher than that of high myopia and the low to moderate group. But its differencewas not statistical significant（P>0.05）.11.The corneal curvatures of all groups were steady after operations. Comparedwith1month, the difference of corneal curvature of all groups at12months aftertreatments do not reach their statistical significance（P>0.05）.Conclusions:1. The treatment of improved Flap-free Epi-LASIK can cure theproblem of high and super-high myopia, and can improve visions of patients. Inaddition, the visions of some patients are even better than their best condition beforeoperations. It has a good effect to those people as well as moderate myopia.2. By using improved Flap-free Epi-LASIK treatment, the high and super-high myopia groups have same early corneal irritation and epithelial recovering time,compared to the low to moderate myopia.3. After improved Flap-free Epi-LASIK treatment, the visions of patients remainedstability. No apparent refractive regression was observed. And it shown a low incidenceof Haze and stable IOP.4. The improved Flap-free Epi-LASIK treatment presents a good predictability,safety, effectiveness as well as stability in curing high and super-high myopia.