Longitudinal Changes in Optical Quality, Spatial Vision, and Depth Vision after Laser Refractive Surgery for Myopia

Area of Science:

• Ophthalmology
• Vision Science
• Biomedical Engineering

Background:

• Laser refractive surgery effectively corrects myopia.
• However, these procedures can lead to long-term deterioration of optical quality.
• This impacts both monocular and binocular visual performance.

Purpose of the Study:

• To systematically analyze longitudinal changes in optical quality.
• To assess high- and low-contrast visual acuity and stereoacuity.
• To compare these changes after three different myopia correction procedures.

Main Methods:

• Prospective cohort study of 106 subjects undergoing laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), or small-incision lenticule extraction (SMILE).
• Measurements included optical quality, high- and low-contrast logMAR acuity, and stereoacuity.
• Data collected pre-operatively and at 1 week, 1, 3, and 6 months post-operatively.

Main Results:

• Refractive correction to within ±0.75 D of emmetropia was achieved in all groups by 6 months.
• Higher-order aberrations, logMAR acuity, and stereoacuity all worsened post-operatively and remained diminished up to 6 months.
• Worsening stereoacuity correlated with both the average and difference in interocular higher-order aberrations; logMAR acuity correlated with the average.

Conclusions:

• Myopia correction surgery leads to sustained loss of optical quality and visual functions up to 6 months post-operatively.
• Both the average and interocular differences in optical quality appear to negatively impact binocular visual functions.
• Symmetric optical quality between eyes may be important for optimizing outcomes after refractive surgery.