A Long-term Outcome Of Advanced Surface Ablation For High And Super High Myopia

PARTⅠ:A Long-term Outcome Of LASEK For High And Super High MyopiaOBJECTIVE To evaluate the long-term outcomes of LASEK.METHODS It was a retrospective case series study.Patients who were treated with LASEK during 2004 and 2005 with high and super high myopia were included.Postoperative assessments were performed at 3 months and 3 years above after surgery including visual acuity,manifest refraction,wavefront aberration and haze.RESULTS The total 71 patients(132 eyes) had a average follow-up of 46±7 months,the mean age is 29.11±9.34 years old.They were divided into 2 groups:73 eyes with high myopia(≥-6D and＜10D),59 eyes with super high myopia(≥-10D).The preoperative mean refractive spherical equivalent(MRSE) is -7.8±1.10D,-12.46±2.43D respectively.Postoperative uncorrected visual acuity(UCVA)≥10/20was noted in 63 eyes(86.3%) of high myopia,21 eyes(35.59%) of super high myopia..1 eyes(1.37%) in high myopia and 4 eyes(6.78%) in super high myopia have best spectacle-corrected visual acuity(BSCVA) lost and 3 eyes(4.11%),15 eyes(25.42%) had BSCVA improved postoperatively.Postoperative MRSE was -0.35±0.53D in high myopia, -1.31±1.58D in super high myopia at 3 months and -1.36±0.97D,-2.45±2.35D at 3 years.64 eyes(87.67%),45 eyes(76.27%) were within±2D of attempted correction respectively.The mean RMS of higher order aberration(HOA-RMS) was significantly high postoperatively which was 0.44±0.14μm,0.51±0.16μm respectively compared with 0.24±0.11μm,0.28±0.11μm preoperatively.It was more obvious in super high myopia.18 eyes(24.66%)in high myopia,17 eyes(28.81%) in super high myopia had haze grade of 0.5 at 3 months postoperatively while 1 eye(1.37%) and 2 eyes(3.39%) at 3 years postoperatively one of which in super high myopia developed haze grade of 1.Conclusions LASEK is a safe and effective procedure for correction of high and super high myopia.But it is less satisfying for super high myopia compared with high myopia.Corneal haze can still exist in the long term. PARTⅡA Long-term Outcome Of Epi-LASIK For High And Super High MyopiaOBJECTIVE To evaluate the long-term outcomes of epi-LASIK for high and super high myopia.METHODS It was a retrospective case series study.Patients who were treated with epi-LASIK during 2004 and 2005 with high and super high myopia were included.Postoperative assessments were performed at 3 months and 3 years above after surgery including visual acuity,manifest refraction,wavefront aberration and haze.RESULTS The total 30 patients(51 eyes) with mean age of 30±8 years old had a average follow-up of 3 months and 20 patients(33 eyes) with mean age of 32±10 years old had 3 years.They were divided into 2 groups:22 eyes with high myopia(≥-6D and＜10D),29 eyes with super high myopia(≥-10D) and it was 17 eyes and 16eyeys at 3 years respectively.The preoperative MRSE is -7.95±1.33D for high myopia,-13.50±2.83D for super high myopia.Postoperative UCVA≥10/20was noted in 17 eyes(100%) of high myopia,5 eyes(31.25%) of super high myopia..1 eyes(5.89%) in high myopia,2 eyes(12.50%) in super high myopia had BSCVA lost and 3 eyes(17.65%) and 9 eyes(56.25%) had BSCVA improved postoperatively.Postoperative MRSE was -0.09±0.31D in high myopia,-2.52±1.82D in super high myopia at 3 months and -0.87±0.75D,-4.62±2.56D at 3 years.16 eyes(94.12%),6 eyes(37.50%) were within±2D of attempted correction respectively. The HOA-RMS was significantly higher postoperatively which was 0.36±0.14μm, 0.46±0.14μm respectively compared with 0.29±0.09μm,0.29±0.14μm preoperatively. It was more obvious in super high myopia.2 eyes(9%)in high myopia,6 eyes(21%) in super high myopia had haze 0.5 at 3 months while extra 2 eyes had haze 1 in super high myopia.And 1 eye(6.25%) in super high myopia still had haze 0.5 at 3 years.Conclusions epi-LASIK has a satisfactory effect for high myopia but less satisfactory result for super high myopia which need more studies of large numbers of patients to confirm.Corneal haze can still exist in the long term in super high myopia. PARTⅢA Long-term Comparison Of Epi-LASIK And LASEK For High And Super High MyopiaOBJECTIVE To compare long-term outcomes of epi-LASIK versus LASEK for high and super high myopia.METHODS It was a retrospective case series study. Patients who were treated with epi-LASIK and LASEK for each eye during 2004 and 2005 with high and super high myopia were included.Postoperative assessments were performed at 3 months and about 3 years after surgery including visual acuity, manifest refraction,wavefront aberration and haze.RESULTS The total 18 patients(36 eyes) with mean age of 31±9 years old had a average follow-up of 35±5 months.They were divided into 2 groups:18 eyes with epi-LASIK and 18 eyes with LASEK.The preoperative MRSE is -10.92±4.07D for epi-LASIK,-10.84±4.11D for LASEK.Postoperative UCVA≥10/20 was noted in 11eyes(61.11%) of both groups.No one had BSCVA lost and 7 eyes(38.89%) in both group had BSCVA improved postoperatively.Postoperative MRSE was -1.0±1.33D,-1.03±1.49D respectively at 3 months and -2.69±2.35D,-2.71±2.41D at 3 years.12 eyes(66.67%) were within±2D of attempted correction in both groups.The HOA-RMS was both significantly higher postoperatively which was 0.47±0.17μm,0.43±0.11μm respectively compared with 0.32±0.16μm,0.31+0.25μm preoperatively.But no differences between the two groups.3 eyes(16.67%) of epi-LASIK,5 eyes(27.78%) of LASEK had haze 0.5 at 3 months while 1(5.56%) eye had haze 1 in LASEK group.All turned completely clear at 3 years.Conclusions epi-LASIK and LASEK offer comaparable results for correction of high and super high myopia.But eyes with LASEK are likely more prone to haze.Overall conclusion:Advanced Surface ablation is a safe and effective procedure for correction of high and super high myopia.But postoperative aberration could be affected.ASA is less satisfying in super high myopia compared with high myopia.More prospective studies of large number of patients are needed to confirm the long-term result.