Advertisement

A Multicenter Prospective Cohort Study on Refractive Surgery in 15 011 Eyes

Published:December 26, 2016DOI:https://doi.org/10.1016/j.ajo.2016.12.009

      Purpose

      To assess the clinical outcomes of currently used refractive surgery procedures performed in 2015.

      Design

      Prospective, multicenter cohort study.

      Methods

      This prospective study included 15 011 eyes of 7622 consecutive patients who underwent laser in situ keratomileusis (LASIK), surface ablation, refractive lenticule extraction (ReLEx), or phakic intraocular lens (IOL) implantation at 42 major institutions. We determined the safety, efficacy, predictability, stability, and adverse events of these surgeries preoperatively and at 1 week and 1 and 3 months postoperatively.

      Results

      Mean logMAR corrected distance visual acuity 3 months after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, or iris-supported phakic IOL implantation was −0.18 ± 0.07, −0.16 ± 0.08, −0.17 ± 0.09, −0.21 ± 0.08, and −0.10 ± 0.12, respectively; the corresponding values for logMAR uncorrected distance visual acuity were −0.15 ± 0.11, −0.12 ± 0.12, −0.12 ± 0.13, −0.15 ± 0.12, and 0.01 ± 0.21, respectively. The percentages within ±1.0 diopter (D) of the attempted correction were 96%, 93%, 97%, 99%, and 84% after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, and iris-supported phakic IOL implantation, respectively. Refractive change from 1 week to 3 months was −0.08 ± 0.07, 0.21 ± 0.63, −0.04 ± 0.41, 0.01 ± 0.31, and 0.01 ± 0.46 D, respectively. No vision-threatening complications occurred during the observation period.

      Conclusions

      Although more prolonged follow-up is still necessary, currently used refractive surgery procedures have good safety and efficacy outcomes, yielding predictable and stable results. Contemporary LASIK, surface ablation, ReLEx, and phakic IOL implantation appear to be feasible options for the treatment of refractive errors.
      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to American Journal of Ophthalmology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Oshika T.
        • Masuda K.
        • Hayashi F.
        • Leaming D.V.
        Current trends in cataract and refractive surgery in Japan–1992 survey.
        Jpn J Ophthalmol. 1993; 37: 432-444
        • Oshika T.
        • Masuda K.
        • Hayashi F.
        • Majima Y.
        • Leaming D.V.
        Current trends in cataract and refractive surgery in Japan–1994 survey.
        Jpn J Ophthalmol. 1995; 39: 265-273
        • Oshika T.
        • Masuda K.
        • Majima Y.
        • Hayashi F.
        • Leaming D.V.
        Current trends in cataract and refractive surgery in Japan–1995 survey.
        Jpn J Ophthalmol. 1996; 40: 419-433
        • Elder M.
        • Tarr K.
        • Leaming D.
        The New Zealand cataract and refractive surgery survey 1997/1998.
        Clin Experiment Ophthalmol. 2000; 28: 89-95
        • Elder M.
        • Leaming D.
        The New Zealand cataract and refractive surgery survey 2001.
        Clin Experiment Ophthalmol. 2003; 31: 114-120
        • Elder M.
        • Leaming D.
        • Hoy B.
        New Zealand cataract and refractive surgery survey 2004.
        Clin Experiment Ophthalmol. 2006; 34: 401-410
        • Pick Z.S.
        • Leaming D.V.
        • Elder M.J.
        The fourth New Zealand cataract and refractive surgery survey: 2007.
        Clin Experiment Ophthalmol. 2008; 36: 604-619
        • Solomon K.D.
        • Fernández de Castro L.E.
        • Sandoval H.P.
        • Bartholomew L.R.
        • Vroman D.T.
        Refractive surgery survey 2003.
        J Cataract Refract Surg. 2004; 30: 1556-1569
        • Sandoval H.P.
        • de Castro L.E.
        • Vroman D.T.
        • Solomon K.D.
        Refractive surgery survey 2004.
        J Cataract Refract Surg. 2005; 31: 221-233
        • Yoon S.C.
        • Jung J.W.
        • Sohn H.J.
        • Shyn K.H.
        Cataract and refractive surgery in ; a survey of KSCRS members from 1995∼2006.
        Korean J Ophthalmol. 2009; 23: 142-147
        • Duffey R.J.
        • Leaming D.
        Trends in refractive surgery in the United States.
        J Cataract Refract Surg. 2004; 30: 1781-1785
        • Bailey M.D.
        • Zadnik K.
        Outcomes of LASIK for myopia with FDA-approved lasers.
        Cornea. 2007; 26: 246-254
        • Yuen L.H.
        • Chan W.K.
        • Koh J.
        • Mehta J.S.
        • Tan D.T.
        • SingLasik Research Group
        A 10-year prospective audit of LASIK outcomes for myopia in 37,932 eyes at a single institution in Asia.
        Ophthalmology. 2010; 117: 1236-1244
        • Sandoval H.P.
        • Donnenfeld E.D.
        • Kohnen T.
        • et al.
        Modern laser in situ keratomileusis outcomes.
        J Cataract Refract Surg. 2016; 42: 1224-1234
        • Hersh P.S.
        • Stulting R.D.
        • Steinert R.F.
        • et al.
        Results of phase III excimer laser photorefractive keratectomy for myopia. The Summit PRK Study Group.
        Ophthalmology. 1997; 104: 1535-1553
        • Koshimizu J.
        • Dhanuka R.
        • Yamaguchi T.
        Ten-year follow-up of photorefractive keratectomy for myopia.
        Graefes Arch Clin Exp Ophthalmol. 2010; 248: 1817-1825
        • Sekundo W.
        • Kunert K.S.
        • Blum M.
        Small incision corneal refractive surgery using the small incision lenticule extraction (SMILE) procedure for the correction of myopia and myopic astigmatism: results of a 6 month prospective study.
        Br J Ophthalmol. 2011; 95: 335-339
        • Amano S.
        • Shimizu K.
        Excimer laser photorefractive keratectomy for myopia: two-year follow up.
        J Refract Surg. 1995; 11: S253-S260
        • Prakash G.
        • Sharma N.
        • Choudhary V.
        • Titiyal J.S.
        Higher-order aberrations in young refractive surgery candidates in India: establishment of normal values and comparison with white and Chinese Asian populations.
        J Cataract Refract Surg. 2008; 34: 1306-1311
        • Lim K.L.
        • Fam H.B.
        Ethnic differences in higher-order aberrations: Spherical aberration in the South East Asian Chinese eye.
        J Cataract Refract Surg. 2009; 35: 2144-2148
        • Albietz J.M.
        • Lenton L.M.
        • McLennan S.G.
        Dry eye after LASIK: comparison of outcomes for Asian and Caucasian eyes.
        Clin Exp Optom. 2005; 88: 89-96
        • Sanders D.R.
        • Doney K.
        • Poco M.
        • ICL in Treatment of Myopia Study Group
        United States Food and Drug Administration clinical trial of the Implantable Collamer Lens (ICL) for moderate to high myopia: three-year follow-up.
        Ophthalmology. 2004; 111: 1683-1692
        • Igarashi A.
        • Shimizu K.
        • Kamiya K.
        Eight-year follow-up of posterior chamber phakic intraocular lens implantation for moderate to high myopia.
        Am J Ophthalmol. 2014; 157: 532-539
        • Tahzib N.G.
        • Nuijts R.M.
        • Wu W.Y.
        • Budo C.J.
        Long-term study of Artisan phakic intraocular lens implantation for the correction of moderate to high myopia: ten-year follow-up results.
        Ophthalmology. 2007; 114: 1133-1142