Laser-assisted in situ keratomileusis in high levels of myopia with the amaris excimer laser using optimized aspherical profiles

摘要

Purpose: To evaluate the clinical outcomes of laser-assisted in situ keratomileusis (LASIK) surgery for the correction of high myopia using a new generation of excimer laser (500-Hz repetition rate) and optimized aspherical profiles. Design: Retrospective interventional case series. Methods: Retrospective study including 51 eyes of 32 patients (age range 23-61 years) with high levels of myopia or myopic astigmatism (spherical equivalent <8.5 diopters [D]). All cases underwent uneventful LASIK surgery using the sixth-generation excimer laser Amaris from Schwind and a femtosecond platform for flap creation. Postoperative changes in visual acuity and refraction were recorded and analyzed during a 6-month follow-up. Results: A significant improvement of about 15 logMAR lines was observed in uncorrected distance visual acuity (UCDVA) at 3 months after surgery (P <.01), with no significant changes afterwards (P =.61). This improvement was consistent with a significant reduction of manifest refraction (P <.01). Best corrected distance visual acuity (BCDVA) remained unchanged or improved in 98% of eyes at 3 months postoperatively, with only 1 eye losing 1 logMAR line of BCDVA. A similar distribution of BCDVA data was observed at 6 months postoperatively. A total of 84.3% of eyes had a postoperative spherical equivalent within ±0.50 D of emmetropia. A limited but significant induction of primary spherical aberration and coma was also found (P <.01). LASIK enhancement was required during the follow-up in only 4 eyes (7.8%). Conclusions: LASIK for high myopia using optimized aspherical profiles and the Amaris excimer laser is a safe, effective, and predictable procedure.