Effectiveness of laser-assisted subepithelial keratectomy without mitomycin-C for the treatment of high myopia

Purpose

To evaluate the effectiveness and therapeutic range of laser-assisted subepithelial keratectomy (LASEK) without mitomycin-C (MMC) to treat high myopia.

Setting

Isık Eye Clinic, Ankara, Turkey.

Methods

This study comprised 31 highly myopic eyes (19 patients) that had LASEK. Before primary LASEK treatment and 1, 3, 6, 12, and 24 months after, all patients had a complete ophthalmic examination including visual acuity, refractive outcomes, and biomicroscopy.

Results

The mean spherical equivalent (SE) was −9.01 diopters (D) ± 2.66 (SD) preoperatively and −1.00 ± 1.15 D at the end of follow-up. At 24 months, the mean SE was within ±1.00 D of the intended correction in 23 eyes (74.19%). The median uncorrected visual acuity (UCVA) increased from 20/606 preoperatively to 20/28.6 at 24 months and the median best corrected visual acuity, from 20/25 to 20/22, respectively. Total higher-order and spherical aberrations increased significantly at the end of follow-up. All 14 eyes that had ablations greater than −8.62 D developed varying degrees of haze. Significant myopic regression (>1.00 D) leading to UCVA loss occurred in all eyes with a preoperative SE of −12.00 D or greater.

Conclusions

The results of LASEK without MMC were excellent in eyes with up to −8.6 D of SE. All eyes with a preoperative SE between −8.6 and −12.0 D developed haze but had acceptable refractive and visual outcomes. Haze and myopic regression limited the success of LASEK in eyes with a preoperative SE of −12.0 D and greater.