Patient satisfaction and visual symptoms after laser in situ keratomileusis☆
Presented at the American Academy of Optometry annual meeting, Philadelphia, Pennsylvania, December 2001, and at the annual meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, May 2002.
Received 11 April 2002; accepted 6 February 2003.
Abstract
Purpose
To examine preoperative risk factors for decreased satisfaction and symptoms of glare, halos, and/or starbursts after laser in situ keratomileusis (LASIK).
Design
Retrospective, case-control study.
Participants
Participants were 604 previously myopic patients who underwent LASIK at least six months prior to completing the questionnaire.
Methods
Questionnaires about satisfaction and night vision symptoms were mailed to 2100 patients from the Northeastern Eye Institute, UCLA, and the University of Pittsburgh. Preoperative and postoperative ocular variables were collected from the medical charts of the 841 subjects who returned the questionnaire.
Main outcome measures
Responses to various satisfaction and night vision symptom questions were compared to demographic and preoperative ocular variables using multivariate logistic regression.
Results
The questionnaire return rate was 42.9%. The mean age for all subjects was 43.0 ± 10.6 years, and 63% of the subjects were women. Overall, 97% of the subjects would recommend LASIK to a friend. Among subjects who would not recommend LASIK to a friend, a significantly larger percentage reported that they experienced glare, halos, or starbursts (13 of 16 (81.3%) vs. 206 of 388 (53.1%), χ2 = 4.9, p = 0.03). Also, subjects with flatter preoperative minimum corneal curvature values were more likely to report that they would not recommend LASIK to a friend (OR = 0.71, 95% confidence interval (CI) = (0.52, 0.96), p = 0.03). The median score for satisfaction with vision was 100%, or the maximum value of 127 mm on the visual analog scale. Increasing age was significantly associated with dissatisfaction with vision after LASIK (OR = 1.68, 95% CI = (1.10, 2.56), P = 0.02). Halos were reported by 30%, glare by 27%, and starbursts by 25% of all subjects. Subjects who reported starbursts had a significantly flatter preoperative minimum corneal curvature (43.54 ± 1.60 D versus 43.92 ± 1.69 D, t = 2.15, p = 0.03). Also, subjects who had surgical enhancement were more likely to experience glare, halos, and/or starbursts (OR = 2.14, 95% CI = (1.33, 3.46), p = 0.002).
Conclusions
Most subjects are satisfied with their vision after LASIK. Our study suggests, however, that certain factors are associated with decreased satisfaction and night vision symptoms after LASIK. Some of these factors include: increasing age, flatter preoperative minimum corneal curvature, and surgical enhancement.
1College of Optometry, The Ohio State University, Columbus, Ohio, USA
2Eye and Ear Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
3Boxer Wachler Vision Institute, Beverly Hills, CA, USA
4UCLA Department of Ophthalmology, Los Angeles, CA, USA
Correspondence and reprint requests to Melissa D. Bailey, OD, MS, The Ohio State University, College of Optometry, 338 West Tenth Avenue, Columbus, OH 43210, USA.
ABSTRACT