title: Clinical outcome of wavefront-guided laser in situ keratomileusis in eyes with moderate to high myopia with thin corneas.
abstract: OBJECTIVE
  To evaluate the clinical outcome of wavefront-guided laser in situ keratomileusis (LASIK) for the treatment of moderate to high myopia associated with a thin cornea.
  
  
  METHODS
  Enaim Laser Medical Center, Tel Aviv, Israel.
  
  
  METHODS
  This retrospective study included 98 eyes of 49 patients with moderate to high myopia (-5.20 to -10.35 diopters [D]) and thin corneas (456 to 498 mum) treated with wavefront-guided LASIK (Zyoptix, Bausch & Lomb) and followed for 36 months. Preoperative wavefront analysis was performed with a Hartmann-Shack aberrometer, and treatment was performed with the Technolas 217 z excimer laser system (Bausch & Lomb). Final refraction data, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), optic zone size, ablation depth, optical aberrations, and night glare complaints were evaluated.
  
  
  RESULTS
  Mean patient age was 28 years +/- 7 (SD), and mean preoperative spherical equivalent refraction was -7.06 D (range -5.20 to -10.35 D). Final UCVA ranged between 6/6 and 6/30. The safety index of the technique was 1.03, and the efficacy index was 0.67. Undercorrection of more than 0.50 D was observed in 41.3% of the high-myopic eyes (-7.00 to -10.35 D, n = 58) compared with 10% in the moderately myopic eyes (-5.00 to -6.75 D, n = 40). A significant reduction in spherical aberration (Z(4)0) was found 12 months postoperatively in all eyes. Night glare was documented in 4 eyes (4%) in the high myopia group. There were no cases of corneal ectasia.
  
  
  CONCLUSIONS
  Zyoptix was safe in eyes with moderate to high myopia with relatively thin corneas (<498 microm). For myopia between -7.00 D and -10.35 D, a small optical zone (4.3 to 5.6 mm) may be applied as night glare was relatively rare, but significant undercorrection should be expected.
authors.affiliation: Enaim Laser Center, Tel Aviv, Israel.
authors.forename: Israel
authors.initials: I
authors.lastname: Kremer
authors.forename: Irit
authors.initials: I
authors.lastname: Bahar
authors.forename: Ami
authors.initials: A
authors.lastname: Hirsh
authors.forename: Shmuel
authors.initials: S
authors.lastname: Levinger
mesh_terms: D000328:Adult; D001837:Body Weights and Measures; D003315:Cornea / Q000000981:diagnostic imaging / Q000473:pathology*; D005500:Follow-Up Studies; D019466:Glare; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D009216:Myopia / Q000145:classification / Q000601:surgery*; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D014792:Visual Acuity / Q000502:physiology