Volume 32, Issue 4 , Pages 577-583, April 2006
Visual experience and patient satisfaction with wavefront-guided laser in situ keratomileusis
Purpose
To determine the correlation between patient perception and clinical measurements after wavefront-guided laser in situ keratomileusis (LASIK).
Setting
Multicenter clinical trial.
Methods
In this retrospective analysis of clinical study results in 274 eyes, wavefront-guided LASIK procedures were performed in 274 myopic-astigmatic eyes at 6 sites. Comprehensive evaluations of vision and ocular health were conducted preoperatively and for 6 months postoperatively. Visual acuity and contrast sensitivity were measured, and questionnaires were administered. Questionnaire responses were compared with clinical measurements.
Results
The overall distribution shifted toward “more satisfied.” The “very satisfied” population increased by as much as 70% in all areas. There was no significant change in frequency of visual symptoms. Patients were more expressive about visual decline than visual improvement. Perception of changes in vision appeared to be related to mesopic contrast sensitivity and mesopic contrast sensitivity under glare. Mesopic pupil diameter was not a major predictor of patient satisfaction. Contact lens wearers were more satisfied with postoperative vision than were spectacle wearers. Men were more likely to report visual symptoms and to complain about night vision, although their changes were the same as those of the women. Residual refractive error was a major predictor for most questionnaire items.
Conclusion
Most patients were as satisfied or more satisfied with their postoperative uncorrected visual acuity than with their preoperative best corrected visual acuity. By continuing to minimize postoperative refractive error through the use of nomograms and improved technology, visual complaints such as night glare and halo could be diminished or even eliminated. The study shows that subjective experience affected satisfaction with results. Some dissatisfaction might be mitigated by being sure patients are educated and have realistic expectations before surgery.
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Dr. Tuan is an employee of Visx, Inc., but has no financial or proprietary interest in any material or method mentioned.Carol F.H. Harner, PhD, helped with the study throughout; the Bascom Palmer Eye Institute, Baylor Vision, Baylor College of Medicine, ColemanVision, Kraff Eye Institute, Maloney Vision Institute, Wilmer Eye Institute, and the VISX Clinical Studies Department helped make the study possible; and Carolyn Hunt assisted with preparing the manuscript.
PII: S0886-3350(06)00005-8
doi:10.1016/j.jcrs.2006.01.002
© 2006 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
Volume 32, Issue 4 , Pages 577-583, April 2006
