title: Laser in situ keratomileusis to correct myopia of -6.00 to -29.00 diopters.
abstract: BACKGROUND
  Photorefractive keratectomy can cause corneal scarring and visual loss in highly myopic eyes. We evaluated laser in situ keratomileusis (LASIK) because it has the theoretical advantage of preserving both the corneal epithelium and Bowman's layer.
  
  
  METHODS
  In a prospective study, LASIK was performed in 62 myopic eyes (42 patients) using the Automatic Corneal Shaper (Chiron Vision) and the Keracor 116 excimer laser (Chiron Technolas). We measured refraction and visual acuity, and evaluated corneal topography (TMS 1) and corneal clarity after 4 to 8 weeks and 4 to 6 months.
  
  
  RESULTS
  Four- to 6-month follow up was completed in 51 eyes. The mean preoperative spherical equivalent refraction was -14.80 diopters (D) (range, -6.00 to -29.00 D). Postoperatively, the mean deviation from the target refraction was -1.70 D (range, -9.00 to +2.50 D) at 4 to 8 weeks and -1.90 D (range, -9.50 to +2.25 D) at 4 to 6 months. At 4 to 6 months, 19 eyes (37%) were within +/- 0.50 D of the target refraction, 24 (47%) within +/- 1.00 D, 33 (65%) within +/- 2.00 D, and 40 (78%) within +/- 3.00 D. From 4 to 8 weeks to 4 to 6 months, the mean regression of myopia was -0.20 D (0.50 D or less in 24 eyes [47%], 1.00 D or less in 32 [63%], and 2.00 D or less in 42 [82%]). In six eyes (12%), the stromal interface was not visible, in 38 (74%) it was barely visible, and in seven (14%) it was clearly visible. Corneal topography revealed only small variations in clear-zone size and dioptric value, demonstrating a very stable correction 4 to 6 months postoperatively.
  
  
  CONCLUSIONS
  LASIK may be a safe and effective procedure to correct high myopia. Further research is required to develop satisfactory microkeratome technology, effective laser algorithms, and to determine long-term stability of refraction.
authors.affiliation: University Eye Hospital, Klinikum Mannheim, Germany.
authors.forename: M C
authors.initials: MC
authors.lastname: Knorz
authors.forename: A
authors.initials: A
authors.lastname: Liermann
authors.forename: V
authors.initials: V
authors.lastname: Seiberth
authors.forename: H
authors.initials: H
authors.lastname: Steiner
authors.forename: B
authors.initials: B
authors.lastname: Wiesinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003315:Cornea / Q000503:physiopathology / Q000601:surgery* / Q000648:ultrastructure; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D053685:Laser Therapy / Q000295:instrumentation*; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009216:Myopia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation; D014792:Visual Acuity