Loss of Best Corrected Visual Acuity after LASIK

ABSTRACT

Loss of best corrected visual acuity(BCVA)is a landmark of safety, as one of important complications of refractive surgery. To evaluate causes of 2 lines or more loss of BCVA after laser in situ keratomileusis(LASIK), 206 eyes of 139 patients, who had undergone LASIK and had been followed up for 6 months or more, were included in this study. During the follow-up, nineteen eyes(9.2%, 19/206)showed 2 lines or more loss of BCVA postoperatively. The causes of BCVA were irregular astigmatism(15 eyes, 7.3%), retinal complications(3 eyes, 1.5%), and infectious keratitis(1 eye, 0.5%). All irregular astigmatisms had occured within 1 month postoperatively and 13 eyes of all 15 eyes spontaneously recovered after postoperative 3 months. The persistent loss of BCVA occurred in 5 eyes(2.4%, 5/206). Three cases of all 5 persistent losses of BCVA were due to retinal complications. In conclusion, our results suggest that the most common cause of loss of BCVA after LASIK is irregular astigmatism. Irregular astigmatism is a temporary situation which has a tendancy of spontaneous recovery. Thus careful observation is recommended in irregular astigmatism after LASIK. The retinal complications of LASIK may lead to permanent loss of BCVA. Therefore it is needed to examine preoperative fundus closely and to explain possible postoperative complicaitons to the patients and their family.