Incidence of retinal disease following refractive surgery in 9,239 eyes

To analyze the appearance, incidence, and characteristics of retinal diseases in myopic patients after refractive surgery.

We studied retinal disease observed in 9,239 consecutive eyes (5,099 patients) after refractive surgery. Photorefractive keratectomy (PRK) was used to correct myopia in 5,936 eyes (3,184 patients, mean age 30.5 +/- 8.9 years); mean spherical equivalent refraction was -4.71 +/- 2.80 D. Laser in situ keratomileusis (LASIK) was used to correct myopia in 3,009 eyes (1,734 patients, mean age 32.0 +/- 7.8 years); mean spherical equivalent refraction was -13.5 +/- 3.30 D. An anterior chamber phakic intraocular lens (PIOL) was implanted to correct myopia in 294 eyes (181 patients, mean age 32.6 +/- 7.3 yr) with a mean spherical equivalent refraction of -18.5 +/- 5.00 D.

Retinal detachment occurred at a mean 53.6 +/- 41.4 months after PRK in 9 eyes (0.15%), 24.6 +/- 20.4 months after LASIK in 11 eyes (0.36%), and 20.5 +/- 17.4 months after anterior chamber PIOL implantation in 12 eyes (4.08%). Choroidal neovascularization occurred a mean 26 months after PRK in 1 eye (0.01%), mean 30.2 +/- 19.3 months after LASIK in 10 eyes (0.33%), and mean 49.0 +/- 33.5 months after PACL implantation in 7 eyes (2.38%). One patient developed a macular hole 12 months after LASIK and another patient developed a macular hemorrhage immediately after LASIK. Epiretinal membrane appeared in one patient 19 months after anterior chamber PIOL implantation.

There was no relationship between PRK for myopia and retinal disease. LASIK for correction of myopia was followed by a low incidence of retinal disease; additional study is necessary to assess the true impact of the suction ring in the myopic eye. Implantation of an anterior chamber PIOL to correct high myopia was followed by a low incidence of choroidal neovascularization, a high incidence of retinal detachment, similar to other intraocular interventions in highly myopic patients.