Five-year outcome of LASIK for myopia

Ophthalmology. 2008 May;115(5):839-844.e2. doi: 10.1016/j.ophtha.2007.07.012. Epub 2007 Sep 27.


Purpose: To investigate the efficacy and safety of LASIK over a 5-year postoperative period.

Design: Observational case series.

Participants: We examined 779 eyes in 402 patients with myopia or myopic astigmatism who underwent LASIK to correct their refractive errors and received regular postoperative assessments for 5 years.

Methods: Postoperative examinations were performed 1 day; 1 week; 1, 3, and 6 months; and 1, 2, 3, 4, and 5 years after LASIK surgery.

Main outcome measures: We evaluated changes in uncorrected visual acuity (UCVA) (logarithm of the minimum angle of resolution [logMAR]), manifest refraction, best-corrected visual acuity (BCVA) (logMAR), intraocular pressure, corneal thickness, corneal endothelial cell counts, and complications.

Results: Preoperative UCVA of 1.27 improved to -0.03 at 1 day after surgery and -0.08 at 1 month and revealed minimal but significant decreases thereafter. Postoperative manifest refraction was also improved by surgery, showing minimal but significant regression after 1 year. Final BCVA loss was seen in 10 eyes of 7 patients; in 7 cases, there were obvious reasons such as the progression of cataracts in 3 eyes, epithelial disintegrity due to dry eye in 2 eyes, irregular astigmatism due to flap striae in 1 eye, and age-related macular dystrophy in 1 eye. Intraocular pressure and corneal thickness decreased by 4.0 mmHg and 76.9 microm, respectively, due to surgery, but remained stable throughout the follow-up period. Corneal endothelial cell counts (2689.0+/-232.9 cells/mm(2) before surgery) showed a statistically significant decrease at 5 years after surgery (2658.0+/-183.1 cells/mm(2); 1.2% loss for 5 years), likely within the range due to physiological age-related loss. No serious, vision-threatening, irreversible complication such as keratectasia or progressive endothelial cell loss was observed.

Conclusion: LASIK surgery is an effective and safe procedure for correcting myopia/myopic astigmatism as long as inclusion and exclusion criteria are strictly respected. However, minimal regression occurred during the 5-year investigative period.

MeSH terms

  • Adult
  • Astigmatism / surgery
  • Cell Count
  • Corneal Stroma / surgery*
  • Endothelium, Corneal / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure / physiology
  • Intraoperative Complications
  • Keratomileusis, Laser In Situ*
  • Lasers, Excimer*
  • Male
  • Middle Aged
  • Myopia / surgery*
  • Patient Satisfaction
  • Postoperative Complications
  • Refraction, Ocular / physiology
  • Surgical Flaps
  • Treatment Outcome
  • Visual Acuity / physiology