Cox proportional hazards model of myopic regression for laser in situ keratomileusis flap creation with a femtosecond laser and with a mechanical microkeratome

Lin, Ming-Hsiu; Chang, David C. K.; Hsu, Wen-Ming; Wang, I‐Jong

doi:10.1016/j.jcrs.2012.01.025

Cited by 12 publications

(15 citation statements)

References 21 publications

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“…The MM-LASIK group was higher risk in myopic regression than the FS-LASIK group, which was similar to Lin et al [18] where the flap configuration and wound adhesion between two methods might contribute to the difference. The planar flap with an FS laser had a stronger wound adhesion than the meniscus flap with a mechanical microkeratome.…”

Section: Methods Of Surgerysupporting

confidence: 85%

“…Previous studies [18,27] produced the same result as ours that higher myopia would contribute to more myopic regression, depending on the amount of treatment.…”

Section: Pre-manifest Se Oz Tz and Aspheric Ablationsupporting

confidence: 87%

“…All the different covariates including the manifest SE in the three groups were adjusted in the Cox proportional hazards model. Though greater manifest SE would present more myopic regression [18], the MM-LASIK group had the highest risk for myopic regression among the three groups, followed by FS-LASIK and LASEK groups, while the MM-LASIK group had the lowest manifest SE.…”

Section: Methods Of Surgerymentioning

confidence: 89%

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Predictors affecting myopic regression in − 6.0D to − 10.0D myopia after laser-assisted subepithelial keratomileusis and laser in situ keratomileusis flap creation with femtosecond laser-assisted or mechanical microkeratome-assisted

Zhou

Gu²,

Li³

et al. 2019

Int Ophthalmol

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Purpose To investigate the predictive factors of postoperative myopic regression among subjects who have undergone laser-assisted subepithelial keratomileusis (LASEK), laser-assisted in situ keratomileusis (LASIK) flap created with a mechanical microkeratome (MM), and LASIK flap created with a femtosecond laser (FS). All recruited patients had a manifest spherical equivalence (SE) from − 6.0D to − 10.0D myopia. Methods This retrospective, observational case series study analyzed outcomes of refraction at 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Predictors affecting myopic regression and other covariates were estimated with the Cox proportional hazards model for the three types of surgeries. Results The study enrolled 496 eyes in the LASEK group, 1054 eyes in the FS-LASIK group, and 910 eyes in the MM-LASIK group. At 12 months, from − 6.0D to − 10.0D myopia showed that the survival rates (no myopic regression) were 52.19%, 59.12%, and 58.79% in the MM-LASIK, FS-LASIK, and LASEK groups, respectively. Risk factors for myopic regression included thicker postoperative central corneal thickness (P ≦ 0.01), older age (P ≦ 0.01), aspherical ablation (P = 0.02), and larger transitional zone (TZ) (P = 0.03). Steeper corneal curvature (Kmax) (P = 0.01), thicker preoperative central corneal thickness (P < 0.01), smaller preoperative myopia (P < 0.01), longer duration of myopia (P = 0.02), with contact lens (P < 0.01), and larger optical zone (OZ) (P = 0.02) were protective factors. Among the three groups, the MM-LASIK had the highest risk of postoperative myopic regression (P < 0.01). Conclusions The MM-LASIK group experienced the highest myopic regression, followed by the FS-LASIK and LASEK groups. Older age, aspheric ablation used, thicker postoperative central corneal thickness, and enlarging TZ contribute to myopic regression; steeper preoperative corneal curvature (Kmax), longer duration of myopia, with contact lens, thicker preoperative central corneal thickness, lower manifest refraction SE, and enlarging OZ prevent postoperative myopic regression in myopia from − 6.0D to − 10.0D.

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Section: Methods Of Surgerysupporting

confidence: 85%

“…Previous studies [18,27] produced the same result as ours that higher myopia would contribute to more myopic regression, depending on the amount of treatment.…”

Section: Pre-manifest Se Oz Tz and Aspheric Ablationsupporting

confidence: 87%

Section: Methods Of Surgerymentioning

confidence: 89%

See 1 more Smart Citation

Predictors affecting myopic regression in − 6.0D to − 10.0D myopia after laser-assisted subepithelial keratomileusis and laser in situ keratomileusis flap creation with femtosecond laser-assisted or mechanical microkeratome-assisted

Zhou

Gu²,

Li³

et al. 2019

Int Ophthalmol

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show abstract

“…Femtosecond laser‐created flaps are planar and more uniform in thickness across the central and peripheral zone, while microkeratome‐created flaps have a thicker peripheral and thinner central zone. It is hypothesised that epithelial hyperplasia on the uneven flap potentially creates a steeper central corneal curvature and may explain the higher regression rates observed amongst eyes with a microkeratome flap . In a prospective study of 102 eyes of 51 patients undergoing myopic LASIK, Durrie and Kezirian randomized one eye of each patient to have the flap created with the IntraLase femtosecond laser and the other with the Hansatome mechanical microkeratome .…”

Section: Risk Factors: Factors Affecting Regressionmentioning

confidence: 99%

“…It is hypothesised that epithelial hyperplasia on the uneven flap potentially creates a steeper central corneal curvature and may explain the higher regression rates observed amongst eyes with a microkeratome flap. 49 In a prospective study of 102 eyes of 51 patients undergoing myopic LASIK, Durrie and Kezirian randomized one eye of each patient to have the flap created with the IntraLase femtosecond laser and the other with the Hansatome mechanical microkeratome. 50 The authors observed that the mean MRSE at 3 months was more myopic with the microkeratome group compared to the femtosecond laser group.…”

Section: Procedural Factors Mechanical Microkeratome Versus Femtosecomentioning

confidence: 99%

Refractive regression after laser in situ keratomileusis

Yan

Chang

Chan

2018

Clinical Exper Ophthalmology

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Uncorrected refractive errors are a leading cause of visual impairment across the world. In today's society, laser in situ keratomileusis (LASIK) has become the most commonly performed surgical procedure to correct refractive errors. However, regression of the initially achieved refractive correction has been a widely observed phenomenon following LASIK since its inception more than two decades ago. Despite technological advances in laser refractive surgery and various proposed management strategies, post-LASIK regression is still frequently observed and has significant implications for the long-term visual performance and quality of life of patients. This review explores the mechanism of refractive regression after both myopic and hyperopic LASIK, predisposing risk factors and its clinical course. In addition, current preventative strategies and therapies are also reviewed.

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Laser-assisted in-situ keratomileusis (LASIK) with a mechanical microkeratome compared to LASIK with a femtosecond laser for LASIK in adults with myopia or myopic astigmatism

Kahuam-López

Navas²,

Castillo‐Salgado

et al. 2020

Cochrane Database of Systematic Reviews

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Cox proportional hazards model of myopic regression for laser in situ keratomileusis flap creation with a femtosecond laser and with a mechanical microkeratome

Abstract: Laser in situ keratomileusis with a mechanical microkeratome had a higher risk for myopic regression than LASIK with a femtosecond laser through 12 months postoperatively.

Cited by 12 publications

References 21 publications

Predictors affecting myopic regression in − 6.0D to − 10.0D myopia after laser-assisted subepithelial keratomileusis and laser in situ keratomileusis flap creation with femtosecond laser-assisted or mechanical microkeratome-assisted

Predictors affecting myopic regression in − 6.0D to − 10.0D myopia after laser-assisted subepithelial keratomileusis and laser in situ keratomileusis flap creation with femtosecond laser-assisted or mechanical microkeratome-assisted

Refractive regression after laser in situ keratomileusis

Laser-assisted in-situ keratomileusis (LASIK) with a mechanical microkeratome compared to LASIK with a femtosecond laser for LASIK in adults with myopia or myopic astigmatism

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