Patient-reported outcomes 5 years after laser in situ keratomileusis

J Cataract Refract Surg. 2016 Jun;42(6):879-89. doi: 10.1016/j.jcrs.2016.03.032.


Purpose: To assess vision-related, quality-of-life outcomes 5 years after laser in situ keratomileusis (LASIK) and determine factors predictive of patient satisfaction.

Setting: Optical Express, Glasgow, Scotland.

Design: Retrospective case series.

Methods: Data from patients who had attended a clinical examination 5 years after LASIK were analyzed. All treatments were performed using the Visx Star S4 IR excimer laser. Patient-reported satisfaction, the effect of eyesight on various activities, visual phenomena, and ocular discomfort were evaluated 5 years postoperatively. Multivariate regression analysis was performed to determine factors affecting patient satisfaction.

Results: The study comprised 2530 patients (4937 eyes) who had LASIK. The mean age at the time of surgery was 42.4 years ± 12.5 (SD), and the preoperative manifest spherical equivalent ranged from -11.0 diopters (D) to +4.88 D. Five years postoperatively, 79.3% of eyes were within ±0.50 D of emmetropia and 77.7% of eyes achieved monocular uncorrected distance visual acuity (UDVA) and 90.6% of eyes achieved binocular UDVA of 20/20 or better. Of the patients, 91.0% said they were satisfied with their vision and 94.9% did not wear distance correction. Less than 2.0% of patients noticed visual phenomena, even with spectacle correction. Major predictors of patient satisfaction 5 years postoperatively were postoperative binocular UDVA (37.6% variance explained by regression model), visual phenomena (relative contribution of 15.0%), preoperative and postoperative sphere and their interactions (11.6%), and eyesight-related difficulties with various activities such as night driving, outdoor activities, and reading (10.2%).

Conclusion: Patient-reported quality-of-life and satisfaction rates remained high 5 years after LASIK. Uncorrected vision was the strongest predictor of satisfaction.

Financial disclosure: Dr. S.C. Schallhorn is a consultant to Abbott Medical Optics, Inc., Zeiss Meditec AG, and Autofocus Inc. and a global medical director for Optical Express. No other author has a financial or proprietary interest in any material or method mentioned.

MeSH terms

  • Adult
  • Female
  • Humans
  • Keratomileusis, Laser In Situ*
  • Lasers, Excimer
  • Male
  • Middle Aged
  • Myopia / therapy*
  • Patient Reported Outcome Measures*
  • Refraction, Ocular
  • Retrospective Studies
  • Treatment Outcome