Refractive and keratometric stability in high myopic LASIK with high-frequency femtosecond and excimer lasers

To evaluate safety, efficacy, ergonomy, and refractive and keratometric stability in high myopia LASIK procedures using a novel femtosecond and excimer laser surgery platform.

One hundred sixteen eyes in consecutive cases of high myopic LASIK ( ≥ -6.00 diopters [D]) with the Alcon-WaveLight FS200 femtosecond and EX500 excimer lasers (Alcon Laboratories, Fort Worth, TX) were evaluated preoperatively and postoperatively for the following parameters: refractive error, corrected distance visual acuity, uncorrected distance visual acuity, spherical equivalent correction, keratometry (with Placido topography and Scheimpflug tomography), and refractive astigmatism. Average follow-up time was 6.2 months (range: 3 to 12 months).

Postoperative average refractive error was -0.37, -0.43, and -0.25 D for the 3-, 6-, and 12-month period, compared to -7.67 ± 1.55 D preoperatively. At 3, 6, and 12 months postoperatively 94%, 96.3%, and 100% of eyes, respectively, were within 1.0 D defocus equivalent. Postoperative refractive astigmatism was -0.21, -0.21, -0.13 D for the 3-, 6-, and 12-month period compared to -1.07 ± 1.91 D preoperatively. The proportion of eyes with postoperative astigmatism within 0.25 D was 85.3%, 81.5%, and 100%, for the 3-, 6-, and 12-month visit, respectively. Keratometric stability was within 0.22 D after the 12-month visit. There was no epithelial ingrowth or diffuse lamellar keratitis in any case.

Clinical outcomes with this technique and technology appear to be promising in high level uncorrected visual rehabilitation of high myopia. There was small regression potential in the sample evaluated.