Long-term results of laser in situ keratomileusis for high myopia: risk for ectasia.
OBJECTIVE
To ascertain the long-term stability of laser in situ keratomileusis (LASIK) in highly myopic eyes.


METHODS
Clinical practice office-based surgery.


METHODS
Charts of eyes with high myopia who had LASIK surgery by the same surgeon between 1994 and 2000 were reviewed in 2003, and patients were given an appointment for follow-up examinations. In these highly myopic eyes, surgery was originally performed to create undercorrections with or without decreasing the ablation diameters to maximally conserve the residual stromal bed thickness.


RESULTS
Of the 107 eyes with myopia between -10.00 diopters (D) and -35.00 D reviewed and operated on in a 3-year period between 1994 and 1998, 35 eyes of 31 patients had a single enhancement procedure. One case of ectasia as a result of excessive tissue removal occurred in a patient with a preoperative refraction of -28.00 D. Of the 107 eyes reviewed, 78 (73%) were examined after 5 years, 68 (63%) after 7 years, and 15 (14%) between 9 years and 11 years.


CONCLUSIONS
Operating on eyes with highly myopic refractive errors and removing substantial tissue thickness did not produce ectasia in this series. Although high myopia has been considered a risk factor for post-LASIK ectasia, adherence to proper screening and intraoperative pachymetry appears to decrease the risk.
Condon
Patrick I
PI
Aut Even Hospital, Kilkenny. pcond@eircorn.net
O'Keefe
Michael
M
Binder
Perry S
PS
D000328:Adult; D015350:Contrast Sensitivity; D003316:Corneal Diseases / Q000209:etiology*; D003319:Corneal Stroma / Q000601:surgery*; D004108:Dilatation, Pathologic; D005260:Female; D005500:Follow-Up Studies; D019466:Glare; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000601:surgery*; D011183:Postoperative Complications; D012029:Refraction, Ocular; D012307:Risk Factors; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity