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Predictive factors for efficacy and safety in refractive surgery for myopia
Nir Gomel1, Shay Negari1,2, Joseph Frucht-Pery1
1Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Plos One
|December 15, 2018
Summary
Predictive factors for myopia refractive surgery success include younger age, male gender, and lower myopia levels. Safety and efficacy outcomes improve over time, with no significant differences found between PRK and LASIK procedures in multivariate analysis.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Myopia Control
Background:
- Laser refractive surgery aims to correct myopia, but understanding predictive factors for safety and efficacy is crucial for patient selection and outcomes.
- Previous studies have explored various factors, yet a comprehensive analysis of predictive elements in a large cohort is valuable.
Purpose of the Study:
- To identify predictive factors influencing the safety and efficacy of laser refractive surgery for myopia.
- To evaluate the impact of patient demographics, pre-operative characteristics, and surgical techniques on refractive surgery outcomes.
Main Methods:
- A retrospective cohort study analyzed 8,775 eyes from 4,623 patients undergoing laser refractive surgery for myopia over 13 years.
- Data included gender, age, surgery type, pre-operative corneal thickness, and Spherical Equivalent (SEQ).
- Safety and efficacy indices were calculated, with cut-off levels set at 0.85 and 0.80, respectively.
Main Results:
- Over 91% of eyes met the safety index threshold and 86% met the efficacy threshold.
- Younger age, male gender, and lower pre-operative myopia (lower SEQ) were significantly associated with higher safety and efficacy.
- While univariate analysis showed differences between Photorefractive Keratectomy (PRK) and Laser Assisted In Situ Keratomileusis (LASIK), multivariate analysis revealed no significant differences in outcomes.
Conclusions:
- Younger age, male gender, and low myopia are key predictors of efficacy in myopia refractive surgery.
- Safety is enhanced in younger patients with low myopia, and safety outcomes have improved over time.
- Multivariate analysis indicates that PRK and LASIK offer comparable safety and efficacy for myopia correction.
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