Simultaneous Accelerated Corneal Crosslinking and Laser In situ Keratomileusis for the Treatment of High Myopia in Asian Eyes

Abstract

Background LASIK Xtra is a recently described technique which combines LASIK and accelerated corneal cross-linking(CXL) in the same setting. Its long-term outcome in Asians with high myopia is not well described. Objectives To compare the efficacy, predictability and safety of LASIK Xtra with LASIK in patients with high myopia. Method This is a retrospective study comparing 50 consecutive eyes undergoing LASIK Xtra for the correction of high myopia and/or myopic astigmatism (-6.63 to -15.50 D manifest spherical equivalent) with a matched control group of 50 eyes undergoing LASIK alone for correction of high myopia (-6.00 to -12.25 D manifest spherical equivalent). Mean follow-up was 5.7 months (range, 1.5-13.3 months) for LASIK Xtra and 3.6 months (range, 1.7-4.2 months) for LASIK only. Outcome measures included Uncorrected Distance Visual Acuity (UDVA), Corrected Distance Visual Acuity (CDVA), refraction and intraoperative and postoperative complications. Results At post-operative 3 months, all eyes achieved UDVA of 20/40 or better, and 80.0% of LASIK Xtra eyes achieved UDVA of 20/20 or better, compared to 66.0% of LASIK only eyes (p = 0.115). Efficacy indices were 0.99±0.17 for LASIK Xtra and 0.94±0.17 for LASIK only (p = 0.164). The proportion of eyes within ±0.50 D of attempted correction was 84% in the LASIK only group and 72% in the LASIK Xtra group at post-operative 3 months (p = 0.148). Safety indices were 1.11±0.19 and 1.11±0.18 in the LASIK Xtra and LASIK only groups, respectively (p = 0.735). Conclusion LASIK Xtra achieved comparable safety, predictability and efficacy as LASIK in patients with high myopia. Good refractive stability was attained at 6-12 months. Further long term studies are required to determine whether simultaneous CXL is able to reduce postoperative LASIK keratectasia in high-risk individuals.