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Femtosecond LASIK for the correction of low and high myopic astigmatism

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Abstract

Introduction

Higher preoperative myopic astigmatism is associated with a higher probability of retreatment due to patient dissatisfaction as a result of residual cylindrical error. Nonetheless, retreatment is safe and the final clinical results are comparable to those of patients with lower preoperative astigmatism who were satisfied with the primary treatment. Our purpose is to compare the efficacy and safety of femtosecond LASIK (FS-LASIK) for the refractive correction of patients with low (< 1.5 Diopters (D) versus high (≥ 1.5 D) myopic astigmatism.

Methods

Retrospective observational study of 841 eyes of 825 eligible patients treated with FSLASIK for the correction of simple or compound myopic astigmatism. Outcome measures included residual error, best corrected and uncorrected distance visual acuity (BCVA and UCVA), efficacy and safety 3 months after the primary procedure or the retreatment.

Results

Of 841 eyes in total, 432 (51.37%) had < 1.5 D (Group 1) and 409 (48.63%) had ≥ 1.5 D (Group 2) preoperative myopic astigmatism. The efficacy index of primary treatment was 0.94 ± 0.18 in Group 1 and 0.89 ± 0.22 in Group 2 (P = 0.001). Of 138 eyes (16.41%) that were retreated due to dis-satisfaction related to residual refractive error, 28 belonged to Group 1 (6.5%) and 110 (26.9%) to Group 2 (P < 0.001). Following retreatment, small but statistically significant differences in the residual mean postoperative cylinder (−0.08 ± 0.24 vs −0.27 ± 0.46 D, P = 0.001) and UCVA (1.11 vs 0.96, P = 0.0001) were detected for Groups 1 and 2, respectively. However, there were no statistically significant differences in the safety and efficacy indices.

Conclusion

Following FS-LASIK, eyes with myopic astigmatism ≥ 1.5 D have approximately four times more chances of undergoing retreatment due to dis-satisfaction caused by residual refractive error compared to eyes with myopic astigmatism < 1.5 D. However, the clinical results after retreatment are highly satisfactory and comparable in both groups.

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Funding

No private or public support was received for this study.

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Authors and Affiliations

  1. Department of Ophthalmology, Príncipe de Asturias University Hospital, University of Alcalá, Av. Víctimas del Terrorismo N5, Pl 8, 1ºA, 28805, Alcalá de Henares, Madrid, Spain

    Rafael Cañones-Zafra, Montserrat Garcia-Gonzalez & Miguel A. Teus

  2. Ophthalmology Department, University of Ioannina, Ioannina, Greece

    Andreas Katsanos

  3. Clínica Novovisión, Madrid, Spain

    Rafael Cañones-Zafra, Montserrat Garcia-Gonzalez & Miguel A. Teus

  4. Clínica Rementería, Madrid, Spain

    Montserrat Garcia-Gonzalez & Juan Gros-Otero

  5. San Pablo CEU University, Madrid, Spain

    Juan Gros-Otero

Authors
  1. Rafael Cañones-Zafra
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  2. Andreas Katsanos
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  3. Montserrat Garcia-Gonzalez
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  4. Juan Gros-Otero
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  5. Miguel A. Teus
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Contributions

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Corresponding author

Correspondence to Rafael Cañones-Zafra.

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Conflict of interest

None of the authors has any financial or proprietary interest in any aspect of this study.

Data availability

The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Consent to participate

The authors received the approval of an institutional review board, the COMITÉ ÉTICO DE INVESTIGACIÓN CLÍNICA REGIONAL DE LA COMUNIDAD DE MADRID (code 216/03, version 2.0 Mayo 2016), and the study conformed to the Helsinki Declaration. All participants accepted the possibility of their data being used to participate in this study by signing the informed consent of their intervention.

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All participants accepted the possibility that their data be published with the signing of the informed consent of their intervention. The tables are original and have been produced by the authors for this particular publication.

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Cañones-Zafra, R., Katsanos, A., Garcia-Gonzalez, M. et al. Femtosecond LASIK for the correction of low and high myopic astigmatism. Int Ophthalmol 42, 73–80 (2022). https://doi.org/10.1007/s10792-021-02001-x

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  • DOI: https://doi.org/10.1007/s10792-021-02001-x

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