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International Ophthalmology
Published in: International Ophthalmology 1/2020

Open Access 01-01-2020 | Keratomileusis | Original Paper

Predictors affecting myopic regression in − 6.0D to − 10.0D myopia after laser-assisted subepithelial keratomileusis and laser in situ keratomileusis flap creation with femtosecond laser-assisted or mechanical microkeratome-assisted

Authors: Jihong Zhou, Wei Gu, Shaowei Li, Lijuan Wu, Yan Gao, Xiuhua Guo

Published in: International Ophthalmology | Issue 1/2020

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Abstract

Purpose

To investigate the predictive factors of postoperative myopic regression among subjects who have undergone laser-assisted subepithelial keratomileusis (LASEK), laser-assisted in situ keratomileusis (LASIK) flap created with a mechanical microkeratome (MM), and LASIK flap created with a femtosecond laser (FS). All recruited patients had a manifest spherical equivalence (SE) from − 6.0D to − 10.0D myopia.

Methods

This retrospective, observational case series study analyzed outcomes of refraction at 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Predictors affecting myopic regression and other covariates were estimated with the Cox proportional hazards model for the three types of surgeries.

Results

The study enrolled 496 eyes in the LASEK group, 1054 eyes in the FS-LASIK group, and 910 eyes in the MM-LASIK group. At 12 months, from − 6.0D to − 10.0D myopia showed that the survival rates (no myopic regression) were 52.19%, 59.12%, and 58.79% in the MM-LASIK, FS-LASIK, and LASEK groups, respectively. Risk factors for myopic regression included thicker postoperative central corneal thickness (P ≦ 0.01), older age (P ≦ 0.01), aspherical ablation (P = 0.02), and larger transitional zone (TZ) (P = 0.03). Steeper corneal curvature (Kmax) (P = 0.01), thicker preoperative central corneal thickness (P < 0.01), smaller preoperative myopia (P < 0.01), longer duration of myopia (P = 0.02), with contact lens (P < 0.01), and larger optical zone (OZ) (P = 0.02) were protective factors. Among the three groups, the MM-LASIK had the highest risk of postoperative myopic regression (P < 0.01).

Conclusions

The MM-LASIK group experienced the highest myopic regression, followed by the FS-LASIK and LASEK groups. Older age, aspheric ablation used, thicker postoperative central corneal thickness, and enlarging TZ contribute to myopic regression; steeper preoperative corneal curvature (Kmax), longer duration of myopia, with contact lens, thicker preoperative central corneal thickness, lower manifest refraction SE, and enlarging OZ prevent postoperative myopic regression in myopia from − 6.0D to − 10.0D.
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Metadata
Title
Predictors affecting myopic regression in − 6.0D to − 10.0D myopia after laser-assisted subepithelial keratomileusis and laser in situ keratomileusis flap creation with femtosecond laser-assisted or mechanical microkeratome-assisted
Authors
Jihong Zhou
Wei Gu
Shaowei Li
Lijuan Wu
Yan Gao
Xiuhua Guo
Publication date
01-01-2020
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 1/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-019-01179-5

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