Laser In Situ Keratomileusis for Primary and Secondary Mixed Astigmatism

To evaluate and compare the efficacy, predictability, and safety of LASIK in the correction of primary and secondary mixed astigmatism after previous LASIK surgery. Retrospective, comparative case series. The retrospective study included 118 eyes having LASIK with the LADARVison 4000 excimer laser (...

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Bibliographic Details
Published in:American journal of ophthalmology 2005-06, Vol.139 (6), p.1019-1027
Main Authors: Jin, George J.C., Merkley, Kevin H., Lyle, W. Andrew
Format: Article
Language:English
Subjects:
Adult
Aged
Astigmatism - etiology
Astigmatism - surgery
Biological and medical sciences
Cornea - surgery
Female
Humans
Keratomileusis, Laser In Situ - methods
Lasers
Male
Medical sciences
Middle Aged
Multivariate analysis
Ophthalmology
Patients
Postoperative Complications - surgery
Reoperation
Retrospective Studies
Safety
Statistical analysis
Surgery
Treatment Outcome
Variance analysis
Vision disorders
Visual Acuity
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Summary:To evaluate and compare the efficacy, predictability, and safety of LASIK in the correction of primary and secondary mixed astigmatism after previous LASIK surgery. Retrospective, comparative case series. The retrospective study included 118 eyes having LASIK with the LADARVison 4000 excimer laser (Alcon Surgical, Orlando, Florida) to correct mixed astigmatism. The eyes were divided into two groups: in group A (n = 64), LASIK was for primary mixed astigmatism and in group B (n = 54), LASIK was for secondary mixed astigmatism. Mean follow-up was 10.6 ± 5.90 months. Overall, the postoperative UCVA was 20/20 in 51% of eyes and 20/40 or better in 97% of eyes at the last visit. The mean refractive cylinder was −2.18 ± 0.94 D preoperatively and −0.56 ± 0.56 D postoperatively. Sixty-one percent of eyes had a refractive cylinder of 0.50 D or less. One eye lost 2 lines of BSCVA (0.8%). None of the eyes had postoperative BSCVA worse than 20/25. The difference of preoperative cylinder was significant between group A and group B ( P = .000). However, there was no statistical difference of postoperative refraction and UCVA between these two groups. At 12 months, the mean vector magnitude achieved was 93% of intended cylinder correction with a mean angle of error of −3.0 ± 16 degrees. LASIK is a safe, effective, and predictable procedure to treat both primary and secondary mixed astigmatism. Nomogram adjustment with spherical and astigmatism components individually may improve refractive outcomes.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2005.01.048