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Survival analysis of myopic regression after small-incision lenticular extraction and femtosecond laser-assisted laser in situ keratomileusis for high myopia

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First Author: Z.Jihong CHINA

Co Author(s):    L. Shaowei   G. Wei   G. Yan   Z. Fengju           

Abstract Details

Purpose:

Predictive factors of myopic regression for high myopia were identified by using Cox proportional hazards model in who had undergone small-incision lenticular extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for 12 months result.

Setting:

Beijing Aier-Intech Eye Hospital, Beijing, China.

Methods:

A retrospective comparative study. Patients with manifest spherical equivalent from -6.0D to -10.0D myopia were recruited. Refractive outcomes were recorded at 1day,1week, 1, 3, 6, and 12 months postoperatively. A Cox proportional hazards model was used to evaluate the impact of the two methods of surgery and other covariates on postoperative myopic regression. Myopic regression was defined as residual myopia﹤-0.50 D and a﹥0.50 D shift toward myopia during the follow-up visits.

Results:

The study enrolled 979 right eyes, 646 in the FS-LASIK group, 333 in the SMILE group. At 12 months, the survival rates were 65.06% in the FS-LASIK group and 62.24% in the SMILE group. Risk factors included age (HR=1.037, P=0.0006), intraocular pressure (IOP) (HR=1.097, P=0.0038), anterior chamber depth (ACD) (HR=2.171, P=0.0067); central corneal thickness (HR=0.993, P=0.0424), corneal curvature Kmax (HR=0.895, P =0.0191), protective factors indicated preoperative manifest spherical equivalent (HR=0.757, P﹤0.0001) and optical zone (OZ) (HR=0.200, P﹤0.0001). The probability of postoperative myopic regression with a small-incision lenticular extraction was higher than femtosecond laser-assisted laser in situ keratomileusis (HR=0.526, P =0.0003) during 12 months.

Conclusions:

12 months postoperatively for myopia from -6.0D to -10.0D, small-incision lenticular extraction (SMILE) was a higher risk of myopic regression than femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). Older age, higher IOP and deeper ACD would contribute to myopic regression. Thicker CCT, steeper corneal curvature (Kmax), lower preoperative manifest sphere and the larger optical zone would prevent myopic regression.

Financial Disclosure:

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