Clinical outcome after in situ laser keratomileusis (LASIK) for myopia:: a series of 390 eyes

Purpose: We report our personal experience with LASIK for myopia to study its efficacy, safety, predictability and stability for low, moderate and high myopia. Patients and methods: Between January 1996 and December 1997, 390 eyes were treated. Follow-up was 6 months for 254 and one year for 136. Initial myopia ranged from -1.5 to -16 diopters with a spherical equivalent of -8.49 D. The surgical procedure with topical anesthesia used the Chiron ALK-E automated corneal shaper for the initial flap of 160 microns thick, and the Chiron Excimer Laser Keracor 117 Technolas with an active eye tracking system for the stromal photoablation. Preoperative refraction, uncorrected (UVA) and best corrected visual acuity (BCVA) were compared to postoperative results. Results: They are reported overall and for sub-groups of myopia. (A less than or equal to 5 D, -5 D<B<less than or equal to>-12 D, -12<C), based on G.O. Waring's recommendations. Efficacy seemed excellent since more than 50 % of eyes obtained an UVA<greater than or equal to>20/40 at 6 months. Average UVA was 0.65 D at one year and was as better as preoperative myopia was lower (group A 0.65 D, group B 0.5 at 6 months). Mean spherical equivalent was +0.08 D at J1 and -1.02 D at one year (group A -0.8 D, group B -0.67 D, and group C -3.92 D). Safety was correct and only a few per and postoperative complications were observed with only two patients losing more than two lines of BCVA. Mean BCVA was 0.72 at one year. Predictability demonstrated that 90% of group A eyes were at +/-1 D from emmetropia and 74% in group B at 6 months. More than 95% of eyes were stable at 6 months and 90% at one year. Conclusion: LASIK is a safe and efficient surgical treatment for low, moderate and high myopia, and should be improved with new software and new corneal shapers.