Clinical Ophthalmology (Sep 2020)
Three-Year Outcomes of Simultaneous Accelerated Corneal Crosslinking and Femto-LASIK for the Treatment of High Myopia in Asian Eyes
Abstract
Li Lim,1– 3,* Elizabeth Wen Ling Lim,4,* Mohamad Rosman,1– 3 Jane Chwee Wah Koh,1 Hla Myint Htoon1,3 1Singapore National Eye Centre, Singapore 168751, Singapore; 2Singapore Eye Research Institute, Singapore 169856, Singapore; 3Duke-NUS Medical School, Singapore 169857, Singapore; 4Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore*These authors contributed equally to this workCorrespondence: Li LimSingapore National Eye Centre, 11 Third Hospital Ave, Singapore 168751, SingaporeTel +65 62277255Fax +65 62277290Email [email protected]: To determine the long-term visual outcomes of simultaneous femtosecond laser-assisted laser in situ keratomileusis (femto-LASIK) and accelerated cross-linking (CXL) [LASIK Xtra] for the treatment of high myopia.Patients and Methods: All 163 consecutive eyes of 85 patients who underwent LASIK Xtra for the treatment of high myopia and/or myopic astigmatism (spherical equivalent ≥ − 6.00 D) in Singapore National Eye Centre from the years 2013 to 2017 were included in this retrospective case series. Post-operative follow-up was up to 3 years.Results: Of the 163 eyes, 67 were followed up for 1 year (mean 12.9 months), 69 for 2 years (mean 24.0 months) and 43 for 3 years (mean 36.4 months). Overall mean follow-up was 22.8 months (9– 46 months). The mean pre-operative spherical equivalent (SE) was − 8.60 ± 1.47 D [range: − 11.75 to − 4.75] (n = 163) and mean attempted correction SE was − 8.84 ± 1.41 D [range: − 11.88 to − 5.25]. Most eyes (> 95%) maintained an uncorrected distance visual acuity of 6/12 or better over 3 years. Visual outcomes were predictable with ≥ 95% of eyes achieving a SE correction within ± 1D of attempted correction over 3 years. There was a mild regression in SE refraction over 3 years with a mean of − 0.10 ± 0.45 D three years post-operatively (p = 0.03). The safety index was > 1.05 at 3 years follow-up. There were no significant post-operative complications though 24 eyes had mild haze and 2 eyes had grade 1 diffuse lamellar keratitis that resolved within 1 month.Conclusion: Our 3-year LASIK Xtra results show favorable safety, efficacy, predictability and stability outcomes in Asian patients with high myopia.Keywords: LASIK Xtra, refractive surgery, cross-linking
