Ten-year follow-up of laser in situ keratomileusis for myopia of up to -10 diopters

PURPOSE: To evaluate the long-term outcomes of laser in situ keratomileusis (LASIK) for myopia of up to -10 diopters (D). DESIGN: A long-term (10-year) follow-up retrospective, interventional case series. METHODS: The study included 97 eyes of 70 patients with a preoperative spherical equivalent (SE) of up to -10 D treated with myopic LASIK at the Instituto Oftalmológico de Alicante, Alicante, Spain, using the VISX 20/20 excimer laser (Santa Clara, California, USA) and the Automated Corneal Shaper microkeratome (Chiron Vision, Irvine, California, USA). All patients were evaluated three months, one year, two years, five years, and 10 years after surgery. The main outcome measures were refractive predictability and stability, mean corneal keratometry, topographical cylinder, safety, efficacy, stability of visual acuity, and postoperative complications. RESULTS: At 10 years, 71 (73%) of 97 eyes were within +/- 1.00 D and 89 (92%) were within +/- 2.00 D. Twenty eyes (20.8%) underwent retreatments because of overcorrection, undercorrection, regression, or both. The mean SE slightly decreased (myopic regression) over 10 years, with a mean myopic regression of -0.12 +/- 0.16 D per year. Fifty-four (54.6%) of 97 eyes demonstrated an increase in best spectacle-corrected visual acuity (BSCVA) after 10 years. No eye developed corneal ectasia in the long-term, and only three eyes lost more than two lines of BSCVA because of complications that were not attributable to the LASIK procedure. CONCLUSIONS: LASIK for myopia of up to -10 D is a safe and effective procedure with slight myopic regression that slows down with time and a high rate of BSCVA increase in the long-term.