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Excimer Laser Treatment for High and Extreme Myopia

Excimer Laser Treatment for High and Extreme Myopia Abstract Objective: The excimer laser allows the controlled ablation of corneal tissue to correct refractive error. We assessed the efficacy of excimer laser treatment for persons with high (spherical equivalent between −5 and −10 diopters) and extreme (spherical equivalent greater than −10 D) myopia. Methods: Patients were assessed 1,3, and 6 months postoperatively. A VisX Twenty/Twenty laser was used. Visual acuity, refraction, corneal clarity, and adverse reactions were evaluated at each visit. Results: Six month follow-up data were available for 194 high myopes and 53 extreme myopes. Postoperative healing was similar for the two groups. Six months postoperatively, 89.2% of high myopes and 49% of extreme myopes were within 2 D of planned refraction. At 6 months, 28% of high myopes had an uncorrected visual acuity of 20/20 and 71% had an uncorrected visual actuity of 20/40. Of extreme myopes, 4% had an uncorrected visual acuity of 20/20 and 30% had an uncorrected visual acuity of 20/40. Significantly more corneal haze was observed in the extreme myopes. Loss of 2 or more lines of best corrected visual acuity was observed in 13% of high myopes and 13% of extreme myopes at 6 months. Conclusions: Excimer laser photorefractive keratectomy is an alternative means of treating high and extreme myopia and can cause a significant reduction in myopia. There is a need to gather further information as more patients are followed up for greater time. References 1. Liu JC, McDonald MB, Varnell R, Andrade A. Myopic excimer laser photorefractive keratectomy . Refract Corneal Surg . 1990;6:321-328. 2. Seiler T, Wollensak J. Myopic photorefractive keratectomy with the excimer laser: one-year follow-up . Ophthalmology . 1991;98:1156-1163.Crossref 3. Sher NA, Chen V, Bowers RA, et al. The use of the 193-nm excimer laser for myopic photorefractive keratectomy in sighted eyes . Arch Ophthalmol . 1991;109:1525-1530.Crossref 4. Gartry DS, Muir MGK, Marshall J. Excimer laser photorefractive keratectomy: 18-month follow-up . Ophthalmology . 1992;99:1209-1219.Crossref 5. Tengroth B, Epstein D, Fagerholm P, Hamberg-Nystrom H, Fitzsimmons TD. Excimer laser photorefractive keratectomy for myopia: clinical results in sighted eyes . Ophthalmology . 1993;100:739-745.Crossref 6. Salz JJ, Maguen E, Nesburn AB, et al. A two-year experience with excimer laser photorefractive keratectomy for myopia . Ophthalmology . 1993;100:873-882.Crossref 7. Taylor HR, Guest CS, Kelly P, Alpins NA. Comparison of excimer laser treatment of astigmatism and myopia . Arch Ophthalmol . 1993;111:1621-1626.Crossref 8. Sher NA, Barak M, Daya S, et al. Excimer laser photorefractive keratectomy in high myopia: a multicenter study . Arch Ophthalmol . 1992;110:935-943.Crossref 9. Ditzen K, Anschütz, Schröder E. Photorefractive keratectomy to treat low, medium, and high myopia . J Cataract Refract Surg . 1994;20:234-238.Crossref 10. Dausch D, Klein R, Schroder E, Dausch B. Excimer laser photorefractive keratectomy with tapered transition zone for high myopia: a preliminary report of six cases . J Cataract Refract Surg . 1993;19:590-594.Crossref 11. Heitzmann J, Binder PS, Kassar BS, Nordan LT. The correction of high myopia using the excimer laser . Arch Ophthalmol . 1993;111:1627-1634.Crossref 12. Alpins NA, A new method of analyzing vectors for planning and understanding changes in astigmatism . J Cataract Refract Surg . 1993;19:524-533.Crossref 13. Waring GO. Conventional standards for reporting results of refractive surgery . Refract Corneal Surg . 1989;5:285-287. 14. McDonnell PJ, Moreira H, Clapman TN, D'Arcy J, Munnerlyn CR. Photorefractive keratectomy for astigmatism . Arch Ophthalmol . 1991;109:1370-1373.Crossref 15. Levin S, Carson CA, Garrett SKM, Taylor HR. The incidence of central islands following excimer laser refractive surgery . Invest Ophthalmol Vis Sci . 1994;35( (suppl 4) ):2018. ARVO abstract. 16. Applegate RA, Howland HC. Magnification and visual acuity in refractive surgery . Arch Ophthalmol . 1993;111:1335-1342.Crossref 17. O'Brart DPS, Lohmann CP, Corbett MC, Klonus G, Kerr-Muir MG, Marshall J. The effects of topical corticosteroids and plasmin inhibitors on refractive outcome, haze and visual performance after photorefractive keratectomy . Invest Ophthalmol Vis Sci . 1994;335( (suppl 4) ):1723. ARVO abstract. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Excimer Laser Treatment for High and Extreme Myopia

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References (26)

Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1995.01100040045025
Publisher site
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Abstract

Abstract Objective: The excimer laser allows the controlled ablation of corneal tissue to correct refractive error. We assessed the efficacy of excimer laser treatment for persons with high (spherical equivalent between −5 and −10 diopters) and extreme (spherical equivalent greater than −10 D) myopia. Methods: Patients were assessed 1,3, and 6 months postoperatively. A VisX Twenty/Twenty laser was used. Visual acuity, refraction, corneal clarity, and adverse reactions were evaluated at each visit. Results: Six month follow-up data were available for 194 high myopes and 53 extreme myopes. Postoperative healing was similar for the two groups. Six months postoperatively, 89.2% of high myopes and 49% of extreme myopes were within 2 D of planned refraction. At 6 months, 28% of high myopes had an uncorrected visual acuity of 20/20 and 71% had an uncorrected visual actuity of 20/40. Of extreme myopes, 4% had an uncorrected visual acuity of 20/20 and 30% had an uncorrected visual acuity of 20/40. Significantly more corneal haze was observed in the extreme myopes. Loss of 2 or more lines of best corrected visual acuity was observed in 13% of high myopes and 13% of extreme myopes at 6 months. Conclusions: Excimer laser photorefractive keratectomy is an alternative means of treating high and extreme myopia and can cause a significant reduction in myopia. There is a need to gather further information as more patients are followed up for greater time. References 1. Liu JC, McDonald MB, Varnell R, Andrade A. Myopic excimer laser photorefractive keratectomy . Refract Corneal Surg . 1990;6:321-328. 2. Seiler T, Wollensak J. Myopic photorefractive keratectomy with the excimer laser: one-year follow-up . Ophthalmology . 1991;98:1156-1163.Crossref 3. Sher NA, Chen V, Bowers RA, et al. The use of the 193-nm excimer laser for myopic photorefractive keratectomy in sighted eyes . Arch Ophthalmol . 1991;109:1525-1530.Crossref 4. Gartry DS, Muir MGK, Marshall J. Excimer laser photorefractive keratectomy: 18-month follow-up . Ophthalmology . 1992;99:1209-1219.Crossref 5. Tengroth B, Epstein D, Fagerholm P, Hamberg-Nystrom H, Fitzsimmons TD. Excimer laser photorefractive keratectomy for myopia: clinical results in sighted eyes . Ophthalmology . 1993;100:739-745.Crossref 6. Salz JJ, Maguen E, Nesburn AB, et al. A two-year experience with excimer laser photorefractive keratectomy for myopia . Ophthalmology . 1993;100:873-882.Crossref 7. Taylor HR, Guest CS, Kelly P, Alpins NA. Comparison of excimer laser treatment of astigmatism and myopia . Arch Ophthalmol . 1993;111:1621-1626.Crossref 8. Sher NA, Barak M, Daya S, et al. Excimer laser photorefractive keratectomy in high myopia: a multicenter study . Arch Ophthalmol . 1992;110:935-943.Crossref 9. Ditzen K, Anschütz, Schröder E. Photorefractive keratectomy to treat low, medium, and high myopia . J Cataract Refract Surg . 1994;20:234-238.Crossref 10. Dausch D, Klein R, Schroder E, Dausch B. Excimer laser photorefractive keratectomy with tapered transition zone for high myopia: a preliminary report of six cases . J Cataract Refract Surg . 1993;19:590-594.Crossref 11. Heitzmann J, Binder PS, Kassar BS, Nordan LT. The correction of high myopia using the excimer laser . Arch Ophthalmol . 1993;111:1627-1634.Crossref 12. Alpins NA, A new method of analyzing vectors for planning and understanding changes in astigmatism . J Cataract Refract Surg . 1993;19:524-533.Crossref 13. Waring GO. Conventional standards for reporting results of refractive surgery . Refract Corneal Surg . 1989;5:285-287. 14. McDonnell PJ, Moreira H, Clapman TN, D'Arcy J, Munnerlyn CR. Photorefractive keratectomy for astigmatism . Arch Ophthalmol . 1991;109:1370-1373.Crossref 15. Levin S, Carson CA, Garrett SKM, Taylor HR. The incidence of central islands following excimer laser refractive surgery . Invest Ophthalmol Vis Sci . 1994;35( (suppl 4) ):2018. ARVO abstract. 16. Applegate RA, Howland HC. Magnification and visual acuity in refractive surgery . Arch Ophthalmol . 1993;111:1335-1342.Crossref 17. O'Brart DPS, Lohmann CP, Corbett MC, Klonus G, Kerr-Muir MG, Marshall J. The effects of topical corticosteroids and plasmin inhibitors on refractive outcome, haze and visual performance after photorefractive keratectomy . Invest Ophthalmol Vis Sci . 1994;335( (suppl 4) ):1723. ARVO abstract.

Journal

Archives of Ophthalmology – American Medical Association

Published: Apr 1, 1995

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