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Predictors of Myopic Regression for Laser-assisted Subepithelial Keratomileusis and Laser-assisted in Situ Keratomileusis Flap Creation with Mechanical Microkeratome and Femtosecond Laser in Low and Moderate Myopia

角膜刀 激光手术 角膜磨镶术 医学 眼科 外科 角膜
作者
Jihong Zhou,Yan Gao,Shaowei Li,Wei Gu,Lijuan Wu,Xiaoxia Guo
出处
期刊:Ophthalmic Epidemiology [Informa]
卷期号:27 (3): 177-185 被引量:6
标识
DOI:10.1080/09286586.2019.1704793
摘要

Purpose: To determine the predictive factors of postoperative myopic regression in subjects who have undergone laser-assisted subepithelial keratomileusis (LASEK), laser-assisted in situ keratomileusis (LASIK) with flaps created using a mechanical microkeratome (MM) or LASIK with flaps created using a femtosecond (FS) laser for −0.50 D to −6.0 D myopia.Materials and Methods: This study was designed as a retrospective comparison. We included 236 eyes in the LASEK group, 1,178 eyes in the MM-LASIK group and 1,333 eyes in the FS-LASIK group. Refractive outcomes were recorded at one day; one week; and one, three, six and 12 months postoperatively. Predictors affecting myopic regression and other covariates were estimated using a Cox proportional hazards model for the three methods of surgery.Results: At 12 months, the survival rates (no myopic regression) were 63.36%, 74% and 77% in the MM-LASIK, LASEK, and FS-LASIK groups, respectively. Risk factors for myopic regression were indicated for patients with greater preoperative central corneal thicknesses (CCT) (P = .02), female patients (P < .01), patients with aspherical ablations (P = .01) and those with larger transitional zones (TZ) (P < .01). Among the three surgeries, MM-LASIK had a significantly higher probability of postoperative myopic regression (P < .01). Longer durations of myopia (P = .03), steeper corneal curvatures (Kmax) (P < .01) and larger optical zones (OZ) (P < .01) were protective factors.Conclusion: MM-LASIK had the highest risk for myopic regression. OZ, TZ, aspherical ablations, preoperative corneal curvatures and being a female patient had significant influence on myopic regression in −0.50 D to −6.0 D myopia.
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