A Comparison of LASIK Outcomes for High Versus Low Myopia: Large Data Analysis

To compare the visual and refractive outcomes of low versus high myopic correction using laser in situ keratomileusis (LASIK) surgery.

Patients who underwent myopic LASIK between January 2013 and December 2023 were included. Eyes were divided into two groups based on preoperative myopia severity: low (0.50 to 3.00 diopters [D]) and high (≥ 6.00 D). Adjustments were made to account for differences in baseline and intraoperative parameters.

In this retrospective study, 12,074 eyes of 6,985 patients were included. Mean spherical equivalent (SEQ) was -6.84 D for high myopia and -2.02 D for low myopia. High myopia was found in 6.7% of patients (n = 813), demonstrating preoperative steeper corneas (maximum keratometry 44.49 vs 44.21 D, P < .001) and worse uncorrected and corrected distance visual acuity (UDVA and CDVA) (2 vs 0.77 logMAR, P < .001; 0.03 vs 0.02 logMAR, P < .001, respectively). Following LASIK, the high myopia group had worse UDVA (0.04 vs 0.01 logMAR, P < .001) and CDVA (0.03 vs 0.01 logMAR, P < .001), higher cylinder (-0.08 vs -0.05 D, P < .001), and SEQ (-0.12 vs -0.07 D, P = .015). Keratometry measurements were flatter in the high myopia group (average: 38.43 vs 41.83 D, P < .001). After accounting for differences in baseline and intraoperative parameters, all of the above-mentioned parameters remained statistically significant. High myopia was not associated with higher re-treatment rates (P = .27).

Although LASIK surgery yielded satisfactory short-term outcomes in both low and high myopia, high myopia showed slightly less favorable refractive results. However, overall results were clinically acceptable in both groups. Similar re-treatment rates may reflect patient satisfaction or variability in surgeons' thresholds for offering enhancement procedures.