Laser in situ keratomileusis to treat myopia: Early experience

Purpose: To present our early experience in methodology and results of laser in situ keratomileusis (LASIK) in treating moderate and high myopia. Setting: Vardinoyannion Eye Institute of Crete and the Cornea and Refractive Surgery Service, Department of Ophthalmology, Heraklion University Hospital, Crete, Greece. Methods: Forty-three moderately to highly myopic eyes had LASIK. Follow-up was between 12 and 24 months. The Draeger's rotor microkeratome was used to create a 150 mu m thick 8.5 x 9.5 mm corneal flap, and the stromal bed was ablated for the myopic correction using the Munnerlynn photorefractive keratectomy algorithm. The preoperative spherical equivalent ranged from -8.50 to -25.87 diopters (D). Attempted correction ranged from 8.00 to 16.00 D. Four eyes developed complications (i.e., anterior chamber perforation and keratoconus, intrastromal epithelial cells, macular lacquer cracks, and transient endothelial decompensation) and were excluded from the study. The remaining 39 eyes were retrospectively divided into two groups-A(21 eyes) and B (18 eyes)-according to the preoperative spherical equivalent (higher or lower than -14.00 D, respectively). Results: Refraction and corneal topography stabilized between 4 and 12 weeks postoperatively. Best spectacle-corrected visual acuity was within one Snellen line in all eyes. At 24 months, 19 eyes (79.2%) were within 2.00 D of intended correction. Attempted correction (12.20 D +/- 2.30 [SD]) was very close to mean achieved correction at 12 and 24 months (11.60 +/- 2.65 D). Mean postoperative astigmatism at 24 months (1.41 +/- 0.87 D; range 0 to 3.50 D) was close to the mean preoperative value (1.52 +/- 1.08 D; range 0 to 4.00 D). An average 2.43% endothelial cell loss was observed at 24 months. Conclusion: With limitations, LASIK could be considered as a treatment for moderate and high myopia.