Comparison of LASIK and Photorefractive Keratectomy for Myopia From -10.00 to -18.00 Diopters 10 Years After Surgery

PURPOSE: To compare the long-term outcomes of LASIK and photorefractive keratectomy (PRK) for high myopia (>=-10.00 diopters [D]). METHODS: This retrospective study included eyes with high myopia that underwent PRK (51 eyes) and LASIK (141 eyes) at the Instituto Oftalmologico de Alicante, Spain, and returned for 10-year follow-up. RESULTS: Ten years after surgery, 45.5% of eyes in the LASIK group achieved uncorrected visual acuity (UCVA) of 20/40 or better compared to 31.3% in the PRK group. Mean efficacy indices after 10 years in both groups were similar (0.87 in the LASIK group and 0.82 in the PRK group, P=.51). Twenty-one (41%) eyes in the PRK group were within +/-1.00 D whereas 60 (42.5%) eyes from the LASIK group were within +/-1.00 D 10 years after surgery. Six (14%) eyes from the PRK group lost 2 or more lines of BSCVA compared to 7 (6%) eyes from the LASIK group. CONCLUSIONS: LASIK and PRK have been shown to have similar visual acuity efficacy in the treatment of eyes with high myopia in the long-term, with LASIK having superior visual acuity efficacy and safety over PRK within the first 2 years after surgery. However, treatment of myopia >=-10.00 D by LASIK is no longer routinely advocated whereas the treatment of high myopia by PRK is no longer performed due to potential complications associated with the treatment. Haze in postoperative PRK eyes was a significant long-term problem in our study. [J Refract Surg. 2010;26:168-176.] doi:10.3928/1081597X-20100224-02