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Changes in quality of life (QOL) related to refractive error after femtosecond laser-assisted LASIK for myopia correction
Session Title: LASIK
Session Date/Time: Wednesday 09/10/2013 | 08:00-10:30
Paper Time: 08:54
Venue: Auditorium (First Floor)
First Author: : A.Meidani GREECE
Co Author(s): : C. Tzavara G. Roussopoulos S. Zoulia Y. Toyntas Murta
To measure the quality of life (QOL) changes in myopic patients having femtosecond assisted LASIK using the Quality of Life Impact of Refractive Correction (QIRC) questionnaire.
Center of Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics Medical School, University of Athens, Greece.
Hypervision Laser Centre.
The validated Greek version of (QIRC) Questionnaire was self-administered by 92 subjects(55,4% men), before and 5-6 months after surgical correction of myopia. Subjects aged 18 to 39 years with myopia (range -0.75 to -8.5D) had corrected distance visual acuity of logMAR 0.2 or better in the worse eye The questionnaire was scored with Rasch analysis. Refractive correction was performed under topical anesthesia using the Visx Star S4 IR excimer laser and the IntraLase FM system with a speed of 60 kHz. In all eyes, the corneal flap was 110±5?m thick. The optical zone size ranged from 6.5mm to 8.5mm with a transition zone. Comparisons before and after surgery were made using Wilcoxon signed rank tests. All reported p values are two-tailed. Statistical significance was set at p<0.05 and analyses were conducted using SPSS statistical software (version 17.0).
The total QIRC score improved with femtosecond-assisted LASIK from a mean ±SD of 38.9±5.7 pre-op to 53.7±5.1 post-op (p<0.001). A significant increase was found for all items (p<0.001) and total QIRC score using responses according to the predominant refractive correction (spectacles or contact lenses). The most significant improvement (more than 25 units) was on the item related to difficulties in swimming, and seeing on waking. There were also significant improvements (20-25 units), on items related to thinking about eyes before doing things, to increasingly reliant upon glasses and to use non Rx sunglasses. The improvement was significant when calculated only for contact lens wearers (p<0.001) or only for spectacle wearers (p<0.001). After surgery women reported a total score (mean 53.1±5.6) that was not significantly different to that of men (mean 54.2±4.7). Before surgery, for individual questions women reported worse QIRC score on items related to driving in glare conditions (p<0.01) and 3 of 7 items in the well-being domain (p<0.05). After surgery, for individual questions men reported better score on the item related to the initial and ongoing cost to buy your current spectacles/contact lenses/refractive surgery (p<0.001) and the cost of unscheduled maintenance of spectacles/contact lenses/refractive surgery (p<0.01).
Femtosecond-assisted LASIK leeds to large improvements in refractive error-related quality of life. We propose that the use of femtosecond laser and wavefront-guided ablation may be responsible for better results in all items given this method carries less induced astigmatism and higher order aberrations (HOA)s.