Long-term Visual and Refractive Outcomes After LASIK for High Myopia and Astigmatism From -8.00 to -14.25 D.

PURPOSE: To evaluate outcomes of high myopic LASIK using the MEL 80 excimer laser (Carl Zeiss Meditec, Jena, Germany). METHODS: Retrospective analysis of 479 consecutive high myopic LASIK procedures (318 patients) using the MEL 80 excimer laser and VisuMax femtosecond laser (Carl Zeiss Meditec) in 77% of cases or zero compression Hansatome microkeratome (Bausch & Lomb, Rochester, NY) in 23% of cases. Inclusion criteria were preoperative spherical equivalent refraction (SEQ) of between -8.00 and -14.25 diopters (D) and corrected distance visual acuity (CDVA) of 20/20 or better. Patients were observed for a minimum of 1 year. Flap thickness was between 80 and 160 µm and optical zone was between 5.75 and 6.50 mm. Standard outcomes analysis was performed. RESULTS: Mean attempted SEQ was -9.39 ± 1.22 D (range: -8.00 to -14.18 D) and mean cylinder was -1.03 ± 0.84 D (range: 0.00 to -4.50 D). Mean age was 37 ± 9 years (range: 21 to 60 years) with 54% female patients. Postoperative SEQ was ±0.50 D in 55% and ±1.00 D in 83% of eyes after primary treatment. After re-treatment, 69% of eyes were within ±0.50 D and 95% were within ±1.00 D. UDVA was 20/20 or better in 89% of eyes after final treatment. One line of CDVA was lost in 3% of eyes and no eyes lost two or more lines. Statistically significant increases (P < .001) were measured in contrast sensitivity (CSV-1000) at 12 and 18 cycles per degree. CONCLUSIONS: The MEL 80 excimer laser was found to achieve high efficacy and safety for treatment of high myopia between -8.00 and -14.25 D and up to -4.50 D of cylinder. [J Refract Surg. 2016;32(5):290-297.].

Outcomes for Myopic LASIK With the MEL 90 excimer laser.

PURPOSE: To evaluate the visual outcomes of myopic LASIK performed with the MEL 90 excimer laser (Carl Zeiss Meditec AG, Jena, Germany) using the Triple-A profile with a 500-Hz pulse rate. METHODS: Retrospective analysis of the first 286 myopic LASIK procedures (147 patients) by two experienced surgeons in which the VisuMax femtosecond laser and MEL 90 excimer laser (Carl Zeiss Meditec) were used following a standardized surgical technique. Inclusion criteria were preoperative spherical equivalent refraction (SEQ) up to -10.38 diopters (D), cylinder up to 5.00 D, and corrected distance visual acuity (CDVA) of 20/25 or better. No nomogram adjustments were made. Patients were observed for 3 months. Flap thickness was between 80 and 110 µm and optical zone was between 6 and 7 mm. Standard outcomes analysis was performed. RESULTS: Preoperatively, mean SEQ was -3.83 ± 1.83 D (range: -0.13 to -10.38 D) and mean cylinder was -0.94 ± 0.86 D (range: 0.00 to -5.00 D). Mean age was 36.4 years (range: 18.2 to 74.1 years) with 50% female patients. Of this population, 138 eyes were treated by one surgeon and 148 eyes by another. The mean predictability of SEQ was -0.13 ± 0.34 D (range: -1.00 to +1.00 D). Postoperative SEQ was ± 0.50 D in 88% and ± 1.00 D in 100% of eyes. Preoperative CDVA was 20/20 or better in 97% of eyes. Postoperative uncorrected distance visual acuity was 20/20 or better in 92% and 20/25 or better in 99% of eyes. One line of CDVA was lost in 6% of eyes and no eyes lost two or more lines. There was statistically significant improvement in mesopic contrast sensitivity (CSV-1000) at 3 (P = .021), 6, 12, and 18 (all P ≤.001) cycles per degree. CONCLUSIONS: The MEL 90 excimer laser using the Triple-A ablation profile with a 500-Hz pulse rate was found to achieve a small but real increase in contrast sensitivity and high efficacy for myopia up to -10.00 D and cylinder up to 5.00 D without the need for a nomogram adjustment.