An interval-censored model for predicting myopic regression after laser in situ keratomileusis.
OBJECTIVE
A time-varying statistical model was proposed to predict the risk of regression toward myopia after laser in situ keratomileusis (LASIK) and to identify significant predictors within a time frame.


METHODS
A total of 615 eyes of 311 patients derived from a retrospective cohort who underwent LASIK in 2003 were analyzed. Refraction outcomes were recorded at 1 day, 1 week, and 1, 3, 6, 9, and 12 months or longer after LASIK. A cross-validated design was used, to split data into trained (n = 308) and validated (n = 307) data sets. These data sets were used in an interval-censored model to predict the probability of regression toward myopia and to assess the predictors including demographic features and preoperative and postoperative variables.


RESULTS
Myopia regression was observed in 164 (26.7%) of 615 eyes during the follow-up period of 12 months or longer after LASIK. Significant predictors for myopia regression after LASIK included preoperative manifest spherical equivalent (P = <0.0001), mean preoperative central corneal curvature (P = 0.001), size of optic zone (P = 0.0043), undercorrection (P = 0.04), and age (P = 0.0734). The risk of regression toward myopia after LASIK increased rapidly within 1 month, slowed down between 1 and 6 months, and became steady after 6 months, regardless of risk group. The risk of myopia regression up to 6 months after LASIK was 21% in average-risk eyes (based on all eyes).


CONCLUSIONS
The proposed interval-censored model was useful not only for predicting the probability of myopia regression after LASIK but also for identifying the evolution of patients within low, moderate, and high-risk groups.
Chen
Yun-I
YI
Department of Ophthalmology, Taipei Hospital, Taipei, Taiwan.
Chien
Kuo-Liong
KL
Wang
I-Jong
IJ
Yen
Amy Ming-Fang
AM
Chen
Li-Sheng
LS
Lin
Pi-Jung
PJ
Chen
Tony Hsiu-Hsi
TH
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000706:statistics & numerical data*; D008297:Male; D015233:Models, Statistical; D009216:Myopia / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011336:Probability; D012372:ROC Curve; D012030:Refractive Errors; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors