ABSTRACT
The purpose of this study was to evaluate the predictability and stability of laser-assisted subepithelial keratectomy (LASEK) with mitomycin C (MMC) in correction of high myopia (≤-6.0 diopters [D]) as compared to low-to-moderate myopia (>-6.0âD).This is a retrospective, comparative, cohort study which included 43 eyes of 43 consecutive patients who underwent LASEK with MMC in a private hospital in Hong Kong by a single surgeon. Twenty-five eyes had high myopia (mean spherical equivalent [SE] = -8.53â±â1.82âD) and 18 eyes had low-to-moderate myopia (mean SE = -3.99â±â1.37âD) before surgery.In terms of refractive predictability, mean SE was significantly better in eyes with preoperative low-to-moderate myopia than high myopia at 6 months (0.04â±â0.23 vs 0.31â±â0.52âD, Pâ=â.035). In terms of refractive stability, between 1 and 3 months, both groups had mean absolute change of SE of around 0.25âD. Between 3 and 6 months, preoperative low-to-moderate myopia group had significantly less absolute change of SE compared to high myopia group (0.07 vs 0.23âD, Pâ=â.003). More eyes with preoperative high myopia changed SE by more than 0.25âD than those with low-to-moderate myopia between 3 and 6 months (32.0% vs 5.6%, Pâ=â.057).In conclusion, LASEK with MMC is more unpredictable and unstable in correction of high myopia than low-to-moderate myopia. The refractive outcome of most low-to-moderate myopia correction stabilizes at 3 months. Stability is not achieved until after 6 months in high myopia correction.
Subject(s)
Keratectomy, Subepithelial, Laser-Assisted , Mitomycin/therapeutic use , Myopia/drug therapy , Myopia/surgery , Nucleic Acid Synthesis Inhibitors/therapeutic use , Adult , Combined Modality Therapy , Female , Hong Kong , Humans , Keratectomy, Subepithelial, Laser-Assisted/adverse effects , Male , Middle Aged , Mitomycin/adverse effects , Nucleic Acid Synthesis Inhibitors/adverse effects , Refraction, Ocular , Retrospective Studies , Severity of Illness Index , Time Factors , Treatment Outcome , Young AdultABSTRACT
PURPOSE: To report the early experience and complications during cataract surgery with a noncontact femtosecond laser system. SETTING: Hong Kong Sanatorium and Hospital, Hong Kong Special Administrative Region, China. DESIGN: Retrospective case series. METHODS: All patients had anterior capsulotomy or combined anterior capsulotomy and lens fragmentation using a noncontact femtosecond laser system (Lensar) before phacoemulsification. Chart and video reviews were performed retrospectively to determine the intraoperative complication rate. Risk factors associated with the complications were also analyzed. RESULTS: One hundred seventy eyes were included. Free-floating capsule buttons were found in 151 eyes (88.8%). No suction break occurred in any case. Radial anterior capsule tears occurred in 9 eyes (5.3%); they did not extend to the equator or posterior capsule. One eye (0.6%) had a posterior capsule tear. No capsular block syndrome developed, and no nuclei were dropped during irrigation/aspiration (I/A). Anterior capsule tags and miosis occurred in 4 eyes (2.4%) and 17 eyes (10.0%), respectively. Different severities of subconjunctival hemorrhages developed in 71 (43.8%) of 162 eyes after the laser procedure. The mean surgical time from the beginning to the end of suction was 6.72 minutes ± 4.57 (SD) (range 2 to 28 minutes). CONCLUSIONS: Cataract surgery with the noncontact femtosecond laser system was safe. No eye lost vision because of complications. Caution should be taken during phacoemulsification and I/A to avoid radial anterior capsule tears and posterior capsule tears.
