Functional, psychological, and satisfaction outcomes of laser in situ keratomileusis for high myopia

Purpose: To identify factors that motivate patients to seek laser in situ k eratomileusis (LASIK) treatment for myopia and establish subjective levels of functional improvement and satisfaction across a range of indices after LASIK surgery. Setting: The Corneal Diseases and Excimer Laser Research Unit, University o f Dundee, Ninewells Hospital and Medical School, Dundee, Scotland. Methods: In this questionnaire-based, cross-sectional study, an anonymous 34-item q uestionnaire was forwarded to 50 consecutive patients in a prospective stud y who had had LASIK for high myopia by a single surgeon at a single center. The questionnaire used visual analog scales, anchored at each end by an ad jectival descriptor. The mean preoperative myopia was -10.7 diopters +/- 4. 4 (SD). Seventy-six percent of eyes (83% of patients) achieved post-LASIK u ncorrected visual acuity (UCVA) of 6/12 or better; 1 eye lost 2 lines of co rrected Snellen visual acuity. Results: A 98% reply rate was achieved. The most common motivating factor f or pursuing LASIK was to improve UCVA (88%); only 21% rated improved cosmes is as an important motive. Most patients (81% to 100%) reported functional improvement across the spectrum of visual tasks assessed, although 8.8% rep orted difficulty with nighttime driving. Ninety-six percent felt their UCVA was as good as anticipated, 97.9% were satisfied with the speed of visual improvement, 93.8% achieved the goals for which they had surgery, 97.9% rep orted an improved quality of life, and 97.9% were satisfied with the overal l outcome of LASIK. Conclusions: Using an anonymous, wide-ranging questionnaire, high levels of functional improvement and satisfaction with the speed of visual recovery and outcome were reported by patients after LASIK for high myopia. Nighttim e driving symptoms of variable severity were, however, noted by 8.8% of pat ients, despite high levels of satisfaction with other aspects of visual fun ction. J Cataract Refract Surg 2000; 26:497-509 (C) 2000 ASCRS and ESCRS.