Laser in situ keratomileusis application for myopia over minus 14 diopter with long-term follow-up.

UNLABELLED: To evaluate the results of laser in situ keratomileusis (LASIK) for extremely high myopia with a minimum follow-up of 10 years. Istanbul Surgery Hospital, Istanbul, Turkey. Extremely high myopic patients treated with LASIK between 1995 and 1997 with a minimum follow-up of 10 years are reviewed retrospectively. Cases over 14 diopters (D) of myopia were included in the study. From 143 eyes with high myopia greater than -14 D operated on between 1995 and 1997, 39 eyes (26 patients) were available for 10-year follow-up. RESULTS: The manifest average spherical equivalent refraction was -21.7 ± 5.8 D prior to surgery. This value became -6.0 ± 3.3 D after at least 10 years of follow-up. The regression was -6.1 ± 2.2 D in the period starting from the first month of the follow-up until the last control. The uncorrected visual acuity was 0.07 ± 0.1 at the last follow-up. The mean preoperative best-corrected visual acuity (BCVA) was 0.22 ± 0.12 and 0.30 ± 0.17 postoperatively (p < 0.001). Loss or gain of one line or more at the BCVA in the last control were 10.3 and 53.8 %, respectively. The safety and efficacy indexes are 1.56 ± 0.95 and 0.29 ± 0.4, respectively. No corneal ectasias were noted at follow-up. Although LASIK gives reliable results with high degrees of myopia, significant regression develops in the long term.

Incidence and management of epithelial loosening after LASIK.

To determine the incidence of recurrent epithelial loosening (REL) following laser in situ keratomileusis (LASIK) and evaluate the efficacy of anterior stromal micropuncture (ASP) and the application of bandage contact lenses (BCLs) in the management of REL after LASIK. A retrospective study including all individuals who underwent LASIK with a microkeratome between January 2006 and January 2007. Medical records were reviewed to identify patients who were diagnosed as having epithelial loosening with or without epithelial defects. Data were collected on 5,566 eyes that underwent LASIK with a microkeratome. Eight eyes (0.14 % or one in 696 eyes) of seven patients had REL with or without epithelial defects. Frequent lubrication, BCL application, and ASP were needed for four eyes (50 %) in the management of REL, respectively. All patients remained free of symptoms after completion of ASP. REL following LASIK is uncommon. Follow-up of patients showed that BCL application and ASP were effective in the management of REL following LASIK.