Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from-10.00 to-13.50 diopters

Background To evaluate laser-assisted in situ keratomileusis (LASIK) outcomes, subjective quality of vision (QoV) and patient satisfaction in eyes with very high myopia (VHM) above - 10.00 diopters (D). Methods Consecutive myopic and myopic-astigmatism eyes with spherical equivalent (SEQ) ranging between - 10.00 to - 13.50 D underwent LASIK with the WaveLight (R) Allegretto Wave (R) Eye-Q 400 Hz excimer laser. Treatment accuracy, efficacy, safety, stability, cylinder vectors, and higher-order aberrations were evaluated, together with subjective QoV and night vision disturbances (NVDs). Results 114 eyes had a preoperative SEQ of - 11.02 +/- 0.81 D, with a median follow-up of 24 months. A total of 72, 84, and 94% of eyes were within +/- 0.50, +/- 0.75 and +/- 1.00 D of intended SEQ (R-2 = 0.71). The efficacy index was 0.93 +/- 0.20, with 51 and 81% of eyes achieving 20/20 and 20/25. The astigmatism correction index was 0.95 +/- 0.33. The safety index was 1.05 +/- 0.12. The average myopic regression was - 0.51 +/- 0.38 D. Preoperative QoV scores improved significantly postoperatively (7.5 +/- 0.8 vs. 9.1 +/- 0.7;P < 0.001), with less NVDs (P < 0.001). Total, spherical and coma root mean square (RMS) postoperative ocular higher-order aberrations were 1.07 +/- 0.34, 0.67 +/- 0.25, and 0.70 +/- 0.40 mu m. Conclusions Very high myopia LASIK between - 10.00 to - 13.50 D is safe and results in good visual outcomes, with high patient satisfaction and a significant improvement in patient-reported QoV after surgery. Appropriately selected patients within this very high myopia group can be included as LASIK candidates.