LASER IN-SITU KERATOMILEUSIS - LITERATURE-REVIEW OF A DEVELOPING TECHNIQUE

We reviewed papers published in peer-reviewed journals describing tech niques and results of laser in situ keratomileusis (LASIK) and summari zed the instruments used, nomograms, preoperative and postoperative re fractions, predictability, outcome, safety, and complications. We perf ormed a similar review of abstracts published in the abstract books of the 1996 meeting of the international Society of Refractive Surgery, the 1997 meeting of the Association for Research in Vision and Ophthal mology, and the 1997 meeting of the American Society oi Cataract and R efractive Surgery. The number of LASIK and photorefractive keratectomy (PRK) patients described in the abstracts were sorted by city. Mean w eighted latitudes were calculated and compared for each procedure. The mean preoperative refraction in the papers was -12.59 diopters (D), w hich was statistically higher than that in the abstracts, -8.71 D (P < .001), and the mean postoperative refraction, -1.10 and +0.93 D, resp ectively. The mean percentage of cases within +/-1.00 D was 67.0% in t he papers and 82.5% tn the abstracts. Uncorrected visual acuity (UCVA) of 20/40 or better was achieved in 49.2% of eyes in the papers and 83 .2% of those in the abstracts; a UCVA of 20/20 or better was achieved in 22.0 and 56.6%, respectively The proportion of eyes that lost two o r more lines of best corrected visual acuity was 8.0% in the papers an d 0.9% in the abstracts. Complications in the papers included irregula r flap (4.0%), incomplete cut (2.5%), free cap (4.9%), perforated lent icule (2,6%), short flap (3.0%), sliding flap (1.4%), interface debris (6.8%), central island (5.3%), decentration (4.7%),epithelial RI ingr owth (4.3%), induced astigmatism (5.1%),wrinkles (5.9%), haze (8.7%), night vision problems (14.0%), and reoperation (8.2%). Mean latitude f or LASIK cases (27.00 degrees +/- 13.73 [SD]) was significantly lower than that for PRK cases (42.85 +/- 11.7 degrees). Visual outcomes of L ASIK surgery show significant improvements When recent abstracts are c ompared with published papers. This may reflect continued improvement in the surgical techniques, surgeons' skills, and visual outcomes.