Visual and Refractive Outcomes of High Myopia Photorefractive Keratectomy With the Alcon Wavelight EX500 Platform...

To evaluate the 12-month visual, refractive, and astigmatic outcomes of a laser vision correction procedure employing an adjusted nomogram in high myopia and explored predictors of success.

This retrospective cohort study enrolled 66 eyes of 66 patients with manifest refraction of ≥-6.50 diopters (D) who underwent photorefractive keratectomy surgery; 50 eyes completed 12 months of follow-up. Standardized nine graphs reporting analyzed efficacy, safety, predictability, stability, and astigmatic vector parameters. Multivariable regression assessed the predictive value of baseline refractive and anatomical factors and ablation depth.

At 12 months, the uncorrected distance visual acuity was 20/20 or better in 92% of eyes, 20/25 or better in 98%, and 20/32 or better in 100%. Seventy-six percent gained one or more line of uncorrected distance visual acuity. Efficacy and safety indices were 1.16 ± 0.24 and 1.18 ± 0.23, respectively. Predictability was high: 96% and 100% of eyes were within ± 0.50 D and ±1.00 D of target, respectively, with no overcorrection. Refractive stability was achieved within 3 months and maintained thereafter (mean Δ spherical equivalent < 0.10 D). Mean cylinder decreased from 0.66 ± 0.50 to 0.06 ± 0.15 D (P < .001), and 94% had 0.25 D residual cylinder. Vector analysis showed close correspondence between intended and achieved astigmatic correction with excellent axis alignment. In this sample, multivariable analysis did not identify independent baseline predictors of outcome.

The Hadassah nomogram demonstrated favorable 12-month efficacy, safety, predictability, and stability in patients with high to very high myopia and astigmatism. Although further validation is required, its simplicity and ease of implementation make it a practical approach that may help improve the accuracy of correction of high myopia with the Wavelight EX500 platform (Alcon Laboratories, Inc).