Prospective, Randomized Comparison of Axial Elongation after LASIK versus Soft Contact Lens Wear in the Contralateral...

To evaluate whether LASIK induces axial elongation comparable to or less than that observed with continued soft contact lens (SCL) wear in myopic eyes.

A prospective, randomized-controlled within-person clinical trial.

Forty-two eyes from 21 patients (11 males, 10 females; mean age: 26 ± 4 years) with myopia or compound myopic astigmatism.

In this contralateral-eye, randomized clinical trial, each participant underwent wavefront-guided (WFG) LASIK in 1 randomly assigned eye, while the fellow eye continued SCL wear. Axial length (AL), spherical equivalent (SE), higher-order aberrations (HOAs), visual acuity, and contrast sensitivity were assessed preoperatively and every 6 months for 2.5 years. The primary outcome was axial elongation from 6 months to 2.5 years postoperatively. Data were analyzed using linear mixed-effects models.

Axial elongation.

The mean preoperative SE in LASIK-treated eyes was -6.23 ± 1.95 diopters. In the early postoperative phase, a significant reduction in AL exceeding corneal thinning was observed, suggesting true axial shortening. From 6 months to 2.5 years, axial elongation did not significantly differ between the LASIK and SCL eyes. Although HOAs at a 6-mm pupil diameter increased more in LASIK-treated eyes, most participants reported subjectively superior visual quality in those eyes.

LASIK was associated with early axial shortening and did not accelerate long-term axial elongation compared with SCL wear. These results suggest a potential modulatory effect of WFG-LASIK on AL progression and support the need for further longitudinal studies.

The authors have no proprietary or commercial interest in any materials discussed in this article.