January 11, 2012
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Epi-LASIK may offer positive long-term outcomes in some higher myopia cases


Eur J Ophthalmol. 2011;doi: 10.5301/ejo.5000025.

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Epi-LASIK yielded positive long-term refractive outcomes and high patient satisfaction in high myopes, but some experienced myopic regression, a study found.

"Phakic intraocular lenses might be an alternative treatment option to provide better refractive outcomes for very high myopia," the study authors said. "However, since the sample size in this study was limited, larger series are needed to confirm the results of epi-LASIK."

The retrospective study included 33 eyes of 20 patients assigned to two groups: 11 patients with preoperative mean refractive spherical equivalent of -6 D to -10 D (group A) and nine patients with mean refractive spherical equivalent greater than -10 D (group B). Average follow-up was 38 months.

Ablation was performed with the MEL 80 excimer laser (Carl Zeiss Meditec).

Visual acuity, manifest refraction and haze were evaluated at 3, 6, 12 and 36 months after surgery.

Study results showed that postoperative regression was significantly greater in group B (P < .05).

At 3 years, 82.35% of eyes in group A and 18.75% of eyes in group B had refraction within 1 D of the target.

The efficacy index was 0.84 in group A and 0.61 in group B; the between-group difference was statistically significant (P < .05).

Between-group differences in uncorrected visual acuity were statistically significant at 36 months (P < .05).

The safety index exceeded 1 at each follow-up interval in each group. Symptoms of haze were moderate and diminished with time, the authors said.