Long Term Follow-Up Safety and Effectiveness of Myopia Refractive Surgery

1) Background: Refractive surgery is an increasingly popular procedure for decreasing spectacle or contact lens dependency. The two most common surgical techniques to correct myopia are photorefractive keratectomy (PRK) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). This study demonstrates the long-term effectiveness, safety, and predictability of both techniques for the refractive surgery of myopia. (2) Methods: A retrospective non-randomized study was performed. We followed 509 PRK eyes and 310 FS-LASIK surgeries for ten years. Patients were followed-up after 3 months and after 1, 2, 5, and 10 years, gathering data on their uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA). The safety index of both procedures was defined as the quotient between the postoperative BCVA and the preoperative BCVA. We defined a procedure as safe if this quotient was equal to or greater than 1. The effectiveness index was calculated as the quotient between postoperative UCVA divided by the preoperative BCVA. (3) Results: The safety index was higher than 1 (1.09) and an effectiveness index of 0.82 after ten years of surgery in both groups was found. (4) Conclusion: These data demonstrated excellent safety and effectiveness indices for both techniques, although FS-LASIK is a technique with better safety and effectiveness indices than PRK

Evaluation of the effectiveness and safety of refractive surgery techniques in high myopia

Tesis doctoral en período de exposición públicaDoctorado en Ciencias Médicas (RD99/11) (8914

Long Term Follow-Up Safety and Effectiveness of Myopia Refractive Surgery

(1) Background: Refractive surgery is an increasingly popular procedure for decreasing spectacle or contact lens dependency. The two most common surgical techniques to correct myopia are photorefractive keratectomy (PRK) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). This study demonstrates the long-term effectiveness, safety, and predictability of both techniques for the refractive surgery of myopia. (2) Methods: A retrospective non-randomized study was performed. We followed 509 PRK eyes and 310 FS-LASIK surgeries for ten years. Patients were followed-up after 3 months and after 1, 2, 5, and 10 years, gathering data on their uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA). The safety index of both procedures was defined as the quotient between the postoperative BCVA and the preoperative BCVA. We defined a procedure as safe if this quotient was equal to or greater than 1. The effectiveness index was calculated as the quotient between postoperative UCVA divided by the preoperative BCVA. (3) Results: The safety index was higher than 1 (1.09) and an effectiveness index of 0.82 after ten years of surgery in both groups was found. (4) Conclusion: These data demonstrated excellent safety and effectiveness indices for both techniques, although FS-LASIK is a technique with better safety and effectiveness indices than PRK

Comparison of Iris-Claw Phakic Lens Implant versus Corneal Laser Techniques in High Myopia: A Five-Year Follow-Up Study

Background. This study aimed to compare the efficacy and safety of Femto-LASIK, PRK, and Artiflex/Artisan phakic lens implantation in the surgical correction of myopia at different moments of postoperative follow-up; to propose a linear predictive model of visual acuity without correction at five years of refractive procedures; and to evaluate its validity. Methods. A retrospective observational analysis was performed. Patients were clinically reviewed after three months, one year, two years, and five years. Univariate and bivariate analyses and a multivariate linear regression model were performed. Results. Six hundred seventy-nine eyes were analyzed: 18.9% Artiflex, 2.8% Artisan, 42.3% Femto-LASIK, and 36.1% PRK. There were significant differences in effectiveness and safety after five years when comparing Artiflex/Artisan versus PRK and Femto-LASIK (p < 0.01). The linear regression model explained 30.32% of the patients’ visual acuity variability after five years. Conclusions. PRK surgery, Femto-Lasik, and Artiflex/Artisan type phakic lens implantation are effective, safe, and predictable techniques with stable refractive results. Phakic lenses magnify myopic patients who improve their UCVA and BCVA. Concerning phakic lens implantation, corneal endothelial cells remain stable. The predictive model calculated that surgery with a phakic lens increased the UCVA result at five years, and surgery with PRK slightly decreased the long-term results