[Influence of visual symptoms on subjective quality of vision after LASIK and pIOL implantation]

The aim of this study was to assess the influence of visual symptoms on subjective quality of vision (SQV) after laser in situ keratomileusis (LASIK) and implantation of an intraocular lens in the phakic eye (pIOL implantation).

Fifty-four myopic patients were included. Forty patients (67 eyes) had uneventful LASIK; in 14 patients (27 eyes) a pIOL was implanted. In the LASIK group the mean age was 37 ± 7 years (pIOL: 36 ± 8); the mean preoperative spherical equivalent was -5.64 ± 1.10 D (pIOL: -7.17 ± 1.39). One month postoperatively all patients completed a questionnaire that differentiated between right and left eye and between three lighting conditions (photopic, high-mesopic and low-mesopic). The intensity of the symptoms "glare", "haloes", "starbursts", "blurred vision", "ghosting" and the SQV were marked on a visual analogue scale (0-100). The influence of the symptoms on SQV was assessed using a multiple regression model.

Under photopic conditions SQV was 22 ± 19 (pIOL: 16 ± 15), under high-mesopic conditions 21 ± 19 (pIOL: 14 ± 13) and under low-mesopic conditions 33 ± 21 (pIOL: 32 ± 19). The coefficients of determination for the three conditions were 0.74 (pIOL: 0.56), 0.68 (pIOL: 0.75) and 0.69 (pIOL: 0.42). After LASIK, the symptoms "glare" and "blurred vision" had the strongest impact on SQV. In the pIOL group, glare, ghosting, haloes and starbursts had a significant influence on SQV.

The present study showed that two-thirds of the variance of SQV could be explained by the symptoms examined in the questionnaire. Blurred vision, ghosting and glare were the symptoms with the most significant influence.