Predictors Of Myopic Regression After Smile, Lasek, Lasik Flap Creation With A Mechanical Microkeratome Or With A Femtosecond Laser In High Myopia

Predict myopic regression for -10.0D to -6.0D myopia for 24 months in those who had experienced SMILE, LASEK, and LASIK flap creation with a mechanical microkeratome and with a femtosecond laser in high myopia

Beijing Aier-Intech Eye Hospital, Beijing, China.

A retrospective comparative study. Patients with the subjective sphere were recruited from -10.0D to -6.0D myopia. Post-refractive outcomes were recorded at 1day,1week, 1, 3, 6, 12, and 24 months. Survival analysis predicts the rate of myopic regression further. The Cox proportional hazards model was utilized to reckon the impact of the four surgery methods and other covariates on postoperative myopic regression. Myopic regression was defined as residual myopia < -0.50 D and a > 0.50 D shift toward myopia during the follow-up visits.

The study contains 2561 patients (2561 right eyes, 921 in the FS-LASIK, in LASEK, 408 in MM-LASIK, and 786 in the SMILE). At 24 months, the survival rates were 57.2% in the FS-LASIK, 63.3% in the LASEK, 64.8% in the MM-LASIK, and 50.5% in the SMILE. The odds of myopic regression were significantly different among the four groups by multivariate analysis (P=0.031). A SMILE was the highest group (HR=2.594); FS-LASIK, LASEK, and MM-LASIK were similar at 24 months. Deeper ablation depth (HR=0.98, P =0.005) may decrease myopic regression. Age (HR=1.06, P=0.001) and high myopia (P=0.041) will forward myopia regression.

24 months postoperatively, SMILE was the highest hazard of myopic regression among FS-LASIK, MM-LASIK, and LASEK; others were similar. Deeper ablation would stem myopic regression for myopia correction from -10.0D to -6.0D. Older age and high sphere were perils of myopic regression.