ESCRS - PP06.10 - Factors Predicting Loss Of Best Corrected Visual Acuity Following Hyperopic Laser-Assisted In Situ Keratomileusis

Factors Predicting Loss Of Best Corrected Visual Acuity Following Hyperopic Laser-Assisted In Situ Keratomileusis

Published 2022 - 40th Congress of the ESCRS

Reference: PP06.10 | Type: ESCRS 2022 - Posters | DOI: 10.82333/c2z8-yq85

Authors: Michael Mimouni* 1 , Igor Kaiserman 2 , Elena Gutkovich 2 , Nir Sorkin 3

1Department of Ophthalmology,Rambam Health Care Campus,Haifa,Israel;Department of Ophthalmology,Rambam Health Care Campus,Haifa,Israel, 2Care Vision Laser Centers,Tel Aviv,Israel, 3Department of Ophthalmology,Tel Aviv Medical Center,Tel Aviv,Israel

Purpose

To identify risk factors for loss of best corrected visual acuity (BCVA) following uncomplicated hyperopic laser-assisted in situ keratomileusis (LASIK).

Setting

Care-Vision Laser Centers, Tel-Aviv, Israel. 

Methods

This retrospective study included hyperopic patients who underwent LASIK by one of five experienced surgeons between January 2000 and December 2019 at Care-Vision Laser Centers, Tel-Aviv, Israel. A minimal follow-up time of one month was required. When two eyes met the inclusion criteria, then one eye was randomly selected. Loss of BCVA was defined as a loss of more than two 0.2 logMAR in vision. Excluded were patients who had loss of BCVA due to intraoperative or postoperative complications as well as those who developed cataract at their final visit.

Results

Overall 1998 eyes were included in the study of which 35 (1.8%) lost two or more lines of BCVA . The vision loss group had a significantly greater spherical treatment (3.4D versus 2.7D, p=0.02), ablation depth (69.4 μm versus 53.8 μm, p=0.01), higher proportion of smaller optic zone treatments (6.0 mm) (31.4% versus 13.4%, p=0.002), proportion of EX200 excimer laser (74.3% versus 39.0%, p<0.001) and treatment with M2 microkeratome as opposed to the SBK microkeratome (55.6% versus 20.8%, p<0.001). In multivariate binary logistic regression, the two factors that remained significant were greater spherical treatment (per 1D change, OR=1.39, 95% CI 1.04-1.86, p=0.03) and the use of the M2 microkeratome (OR=4.78, 95% CI 2.21-10.32, p<0.001).

Conclusions

A greater ablation depth is associated with a higher risk for vision loss following uncomplicated hyperopic LASIK. The transition to newer excimer laser and microkeratome models seems to have reduced vision loss rates.