Surgical options and clinical outcomes for high myopia

• Published in: Current opinion in ophthalmology Vol. 35; no. 4; p. 284
• Main Authors: Abing, Ashley A, Oh, Alyce, Ong, Lauren F, Marvasti, Amir H, Tran, Dan B, Lee, Jimmy K
• Format: Journal Article
• Language: English
• Published: United States 01.07.2024
• Subjects: Adult; Female; Humans; Keratomileusis, Laser In Situ - methods; Lens Implantation, Intraocular - methods; Male; Myopia - physiopathology; Myopia - surgery; Myopia, Degenerative - physiopathology; Myopia, Degenerative - surgery; Phakic Intraocular Lenses; Photorefractive Keratectomy - methods; Refraction, Ocular - physiology; Retrospective Studies; Treatment Outcome; Visual Acuity - physiology
• ISSN: 1531-7021
• DOI: 10.1097/ICU.0000000000001053

Higher degrees of myopia are currently being treated with refractive surgery. However, there is limited characterization and outcomes data for this cohort. This article aims to review the literature on highly myopic patients who had refractive surgery and present a retrospective analysis of 149 patients (270 eyes) with high to extreme myopia (≤-5.0D SE) who underwent refractive surgery [laser-assisted subepithelial keratomileusis (LASIK), photorefractive keratectomy (PRK), or implantable collamer lense (ICL)] at a single practice. There is substantial literature on the efficacy of LASIK, PRK, and phakic intraocular lenses for refractive error correction, but a dearth of studies on patients with high to extreme myopia undergoing different types of refractive surgery. Our study reveals that this cohort of patients has excellent outcomes with minimal complications. Our study reveals that the average preoperative myopia was highest in ICL patients (-10.03D), followed by PRK (-7.21D), and LASIK (-7.04D) patients. Not surprisingly, eyes with high myopia and thin corneas were offered and elected ICLs for their procedure. Highly myopic patients achieved outcomes consistent with data reported in the literature- average postoperative uncorrected visual acuity was 20/20 for LASIK and ICL eyes and 20/25 for PRK eyes.