EXCIMER laser vision correction in the form of LASIK and PRK/LASEK has been proved to be highly effective and safe in the treatment of low-to moderate myopia (less than -6 diopters [D]) and astigmatism. It is the most common refractive-surgery procedure done worldwide. However, the outcome of laser vision correction among those with high myopia (greater than -6D) may not be the same as in those with low to moderate myopia CLINICAL SCENARIO: A 26-year-old, female, myopic patient unhappy with spectacle correction and contact lenses heard about LASIK and sought opinion regarding the probability of her achieving 20/20 vision. Her last refraction was -7.00 sphere -1.00 cylinder x 100 in the right eye (OD) and -9.00 sphere -0.50 cylinder x 90 in the left eye (OS). Best-corrected visual acuity (BCVA) was 20/20 OD and 20/20 OS. Her refraction has been stable for 5 years CLINICAL QUESTION: The patient has high myopia and is concerned about her chances of seeing 20/20 after undergoing laser vision correction. Among patients with high myopia, how effective is LASIK in achieving 20/20 vision? SEARCH METHOD: An electronic literature search was performed using MEDLINE (PubMed). The following search terms were used: "Myopia," "LASIK," "laser in situ keratomileusis," "technology assessment." The search was further limited to the English language and human studies published from 1968 to April 2005. The search yielded 5 articles but only one was relevant to the clinical question CITATION: Sugar A, Rapuano CJ, Culbertson WW, et al. Laser in situ keratomileusis for myopia and astigmatism: safety and efficacy. A Report by the American Academy of Ophthalmology. Ophthalmology 2002; 109:175-187. (Author)
LASER SURGERY, KERATOMILENSIS, LASER IN SITU, KERATECTOMY, LASER