title: Effect of postoperative keratometry on quality of vision in the postoperative period after myopic wavefront-guided laser in situ keratomileusis.
abstract: OBJECTIVE
  To determine whether postoperative keratometry is a predictor of patient-reported satisfaction and night-vision phenomena after wavefront-guided myopic laser in situ keratomileusis (LASIK).
  
  
  METHODS
  Optical Express, Glasgow, United Kingdom.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Myopic eyes treated with wavefront-guided LASIK were analyzed in this study. All patients completed pre-operative and 1-month postoperative questionnaires, in which the satisfaction with visual outcomes and pre-operative and postoperative night-vision symptoms (glare, halos, starburst, ghosting/double-vision) were rated. Multivariate regression analysis was performed to determine factors associated with questionnaire outcomes.
  
  
  RESULTS
  This study evaluated 8672 myopic eyes of 4602 patients. The mean pre-operative manifest spherical equivalent was -3.72 diopters (D) ± 2.00 (SD) (range -0.50 to -11.00 D) and the mean pre-operative keratometry (K) value was 43.64 ± 1.43 D (38.38 to 49.00). At 1 month after surgery, 93.7% and 99.1% of eyes were within 0.50 D and 1.00 D of emmetropia, and 94.6% and 98.3% of eyes achieved monocular and binocular uncorrected-distance visual acuity(UDVA) of 20/20 or better, respectively. There were 48.7% of eyes that had the flat corneal meridian (minimum K) of 40.0 D or less. Although postoperative keratometry was a significant predictor of patient-reported satisfaction and the change in halo reports in the regression analysis, its relative contribution was very low and accounted for less than 0.50% of the variance explained by either model. Postoperative keratometry was not a significant predictor of a change in reports of glare, starburst, and ghosting or double vision.
  
  
  CONCLUSIONS
  In this large cohort of patients, postoperative keratometry played a minimal and clinically insignificant role in predicting post-LASIK halo visual phenomena and patient-reported satisfaction.
  
  
  BACKGROUND
  Dr. Schallhorn is a consultant to Abbott Medical Optics and Zeiss and a Global Medical Director for Optical Express. None of the other authors have a financial or proprietary interest in the products and materials presented in this paper.
authors.affiliation: From University of California San Francisco (Schallhorn), San Francisco, California, USA, and Optical Express (Schallhorn, Venter, Hannan, Hettinger, Teenan), Glasgow, United Kingdom. Electronic address: scschallhorn@yahoo.com.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Schallhorn
authors.affiliation: From University of California San Francisco (Schallhorn), San Francisco, California, USA, and Optical Express (Schallhorn, Venter, Hannan, Hettinger, Teenan), Glasgow, United Kingdom.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Venter
authors.affiliation: From University of California San Francisco (Schallhorn), San Francisco, California, USA, and Optical Express (Schallhorn, Venter, Hannan, Hettinger, Teenan), Glasgow, United Kingdom.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Hannan
authors.affiliation: From University of California San Francisco (Schallhorn), San Francisco, California, USA, and Optical Express (Schallhorn, Venter, Hannan, Hettinger, Teenan), Glasgow, United Kingdom.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Hettinger
authors.affiliation: From University of California San Francisco (Schallhorn), San Francisco, California, USA, and Optical Express (Schallhorn, Venter, Hannan, Hettinger, Teenan), Glasgow, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Teenan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003315:Cornea / Q000502:physiology*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D011184:Postoperative Period; D011787:Quality of Health Care; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*