Effectiveness of laser-assisted subepithelial keratectomy without mitomycin-C for the treatment of high myopia

PURPOSE: To evaluate the effectiveness and therapeutic range of laser-assisted subepithelial keratectomy (LASEK) without mitomycin-C (MMC) to treat high myopia. SETTING: Isik Eye Clinic, Ankara, Turkey. METHODS: This study comprised 31 highly myopic eyes (19 patients) that had LASEK. Before primary LASEK treatment and 1, 3, 6, 12, and 24 months after, all patients had a complete ophthalmic examination including visual acuity, refractive outcomes, and biomicroscopy. RESULTS: The mean spherical equivalent (SE) was -9.01 diopters (D) +/- 2.66 (SD) preoperatively and -1.00 +/- 1.15 D at the end of follow-up. At 24 months, the mean SE was within +/- 1.00 D of the intended correction in 23 eyes (74.19%). The median uncorrected visual acuity (UCVA) increased from 20/606 preoperatively to 20/28.6 at 24 months and the median best corrected visual acuity, from 20/25 to 20/22, respectively. Total higher-order and spherical aberrations increased significantly at the end of follow-up. All 14 eyes that had ablations greater than -8.62 D developed varying degrees of haze. Significant myopic regression (>1.00 D) leading to UCVA loss occurred in all eyes with a preoperative SE of -12.00 D or greater. CONCLUSIONS: The results of LASEK without MMC were excellent in eyes with up to -8.6 D of SE. All eyes with a preoperative SE between -8.6 and -12.0 D developed haze but had acceptable refractive and visual outcomes. Haze and myopic regression limited the success of LASEK in eyes with a preoperative SE of -12.0 D and greater.