Long-term Visual and Refractive Outcomes After LASIK for High Myopia and Astigmatism From-8.00 to-14.25 D

PURPOSE: To evaluate outcomes of high myopic LASIK using the MEL 80 excimer laser (Carl Zeiss Meditec, Jena, Germany). METHODS: Retrospective analysis of 479 consecutive high myopic LASIK procedures (318 patients) using the MEL 80 excimer laser and VisuMax femtosecond laser (Carl Zeiss Meditec) in 77% of cases or zero compression Hansatome microkeratome (Bausch & Lomb, Rochester, NY) in 23% of cases. Inclusion criteria were preoperative spherical equivalent refraction (SEQ) of between -8.00 and -14.25 diopters (D) and corrected distance visual acuity (CDVA) of 20/20 or better. Patients were observed for a minimum of 1 year. Flap thickness was between 80 and 160 mu m and optical zone was between 5.75 and 6.50 mm. Standard outcomes analysis was performed. RESULTS: Mean attempted SEQ was -9.39 +/- 1.22 D (range: -8.00 to -14.18 D) and mean cylinder was -1.03 +/- 0.84 D (range: 0.00 to -4.50 D). Mean age was 37 +/- 9 years (range: 21 to 60 years) with 54% female patients. Postoperative SEQ was +/- 0.50 D in 55% and +/- 1.00 D in 83% of eyes after primary treatment. After re-treatment, 69% of eyes were within +/- 0.50 D and 95% were within +/- 1.00 D. UDVA was 20/20 or better in 89% of eyes after final treatment. One line of CDVA was lost in 3% of eyes and no eyes lost two or more lines. Statistically significant increases (P<.001) were measured in contrast sensitivity (CSV-1000) at 12 and 18 cycles per degree. CONCLUSIONS: The MEL 80 excimer laser was found to achieve high efficacy and safety for treatment of high myopia between -8.00 and -14.25 D and up to -4.50 D of cylinder.