Long-term refractive results after multizone LASIK for extreme myopia

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Presentation transcript:

Long-term refractive results after multizone LASIK for extreme myopia Faik Oruçoğlu (Orucov) Kudret Eye Hospital / Istanbul Good afternoon. Today I am going to talk about extreme myopia and the long-term effects and success on patients with this eye defect.

To evaluate the long-term results of LASIK for extreme myopia The purpose was to get a better understanding of the effects LASIK has on extreme myopia.

39 eyes (N 23) Over - 14 D of myopia LASIK between 1995 and 1997 Minimum of 10 years follow-up 39 eyes (N 23) The method of evaluation is from a total of 23 patients and specifically 39 eyes with at least – 14 D of myopia. All operations were made between 1995-1997. Therefore each individual case has had a minimum of 10 years for observation.

Table 1. Preoperative - Postoperative follow-up periods and SE change. Parameter Eyes N Mean SEQ (D) Range SEQ (D) Preoperative 143 -20.38±5.16 -38.0-14.13 Postoperative 1.Day 93 1.71±2.47 -7.0+7.50 1. Month 87 -0.69±3.10 -16+4.50 3. Month 71 -2.09±3.03 -15.0+2.0 6. Month 49 -2.97±3.33 -18.0+1.50 1.Year 43 -2.88±2.15 -10.0+0.50 2.Year 22 -3.58±3.41 -14.25±0.75 4. Year 19 -4.57±3.23 -13.0±-1.50 6. Year 17 -5.57±3.85 -13-0.75 8.Year 18 -5.88±3.00 -12.75-1.13 Last (from 10 to15 Years) 39 -6.09±3.35 -14.38-0.50

Regression 1 month - last F/U -6.1± 2.2 D as you can see a dramatic improvement is achieved soon after the operation. However can I just point out for example the regression from 1 month to the last examination at the minimum of 10 years is roughly -6.0 D and regression after 1year to last examination is around -3. This concludes that the regression rate is higher in the first year after the op. than following 10 years. Regression 1 month - last F/U -6.1± 2.2 D 1 year - last F/U -3.07±1.8 D

Preoperative 1y Last F/U (Mean 12.5 y ) SE -20.38 ± 5.16 -2.88±2.15 D (Eyes (%)/Total Eyes) NONE 6 (14%) / 43 - ± 2.0 D 20 (46.5%) / 43 4 (10.3%) /39 UCVA FC 0.20±0.14 0.06±0.13 UCVA ≥ 20/40 4 (9.3%) / 43 1 (2.6%) /39 Efficacy index 0.56 0.29 BCVA 0.23±0.12 0.33±0.14 0.31±0.16 BSCVA ≥ 20/40 26 (18.2%) /143 10 (23.2%) / 43 7 (20.6%) /39 Safety index 1.37 1.48

Pentacam*– Last F/U Mean (SD) Range K1 (flat) (D) 35.9±2.4 30.8-39.4 (steep) (D) 36.9±2.5 31.5-43.3 Flattest K (D) 32.6±3.6 26.3-38.3 Topographic astigmatism (D) 1.1±0.86 00-4.3 Q value 2.4±0.8 1.1-3.9 Pachymetry (μm) 422.4±55.7 335-596 BFS Front -22.6 ±7.1 -43.0-11.0 BFS Back 34.3±36.0 -2.0+126.0 Can I just draw your attention to the last Pentacam topography *Corneal topographic analysis showed an evident oblate contour with no irregular astigmatism or ectasia.

14 eyes (35.9%) eyes maintained 4 (10.3%) lost one / two lines BSCVA 21 (53.8%) gained at least one 14 eyes (35.9%) eyes maintained 4 (10.3%) lost one / two lines Of the 39 eyes in total, the majority maintained or increased by 1 or 2 lines in BCVA.

30. 12. 1995 LASIK RE/ Pre-op; FC -25. 0 0,2 Post-op; 0. 2 -1. 0 (-1 30.12.1995 LASIK RE/ Pre-op; FC -25.0 0,2 Post-op; 0.2 -1.0 (-1.0x25) ile 0.4(3H) Fundus view and postoperative topography (10 years after) Now just for your interest we can take a look at one particular case. Back in 1995 a patient had LASIK with myopia at -25.0. At post op the patients UCVA was 0.2 and BCVA improved to 0.4.

Although LASIK gives reliable results with high degrees of myopia, significant regression develops in the long term. SO finally to conclude. Although LASIK gives reliable results with high degrees of myopia, significant regression develops in the long term.