title: Short-term Variance of Refractive Outcomes After Simultaneous LASIK and High-Fluence Cross-linking in High Myopic Correction.
abstract: OBJECTIVE
  To analyze the visual and refractive outcomes of LASIK with and without simultaneous cross-linking for correction of myopia.
  
  
  METHODS
  Patients who received femtosecond laser-assisted LASIK with and without adjunctive cross-linking according to patient's preference were examined longitudinally for 6 months. Patients with myopic manifest refraction spherical equivalent of 5.00 diopters (D) or greater and estimated residual stromal thickness of greater than 250 µm were included.
  
  
  RESULTS
  Overall, 120 eyes of 60 patients were included (60 eyes of 30 patients for LASIK with cross-linking; 60 eyes of 30 patients with LASIK only). No significant difference was observed in age, preoperative corrected distance visual acuity, manifest refraction spherical equivalent, manifest sphere and cylinder, minimal corneal thickness, and residual stromal bed thickness between both groups (P ≥ .245). The uncorrected distance visual acuity and efficacy index were significantly worse on day 1 in eyes receiving adjunctive cross-linking (P = .0001). At 6 months, 86.7% and 95% of the eyes achieved uncorrected distance visual acuity of 20/25 or better in LASIK with cross-linking and LASIK only, respectively. The variance of postoperative spherical equivalent and sphere was significantly higher in eyes undergoing LASIK with cross-linking from 1 week up to 6 months compared to LASIK only (P ≤ .002). None of the patients required re-treatment up to 6 months postoperatively.
  
  
  CONCLUSIONS
  Adjunctive cross-linking during LASIK was associated with worse visual outcomes during the first postoperative week. The variance of spherical equivalent was also high in these patients over a 6-month follow-up. [J Refract Surg. 2016;32(10):664-670.].
authors.forename: Tommy C Y
authors.initials: TC
authors.lastname: Chan
authors.forename: Marco C Y
authors.initials: MC
authors.lastname: Yu
authors.forename: Alex L K
authors.initials: AL
authors.lastname: Ng
authors.forename: George P M
authors.initials: GP
authors.lastname: Cheng
authors.forename: Jiamei
authors.initials: J
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Vishal
authors.initials: V
authors.lastname: Jhanji
mesh_terms: D000328:Adult; D003094:Collagen / Q000378:metabolism; D003131:Combined Modality Therapy; D063171:Corneal Pachymetry; D003319:Corneal Stroma / Q000378:metabolism; D019781:Corneal Topography; D003432:Cross-Linking Reagents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D012029:Refraction, Ocular / Q000502:physiology; D012256:Riboflavin / Q000627:therapeutic use*; D016896:Treatment Outcome; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin