Presented in part at the American Academy of Ophthalmology annual meeting, New Orleans, Louisiana, November 2001, and at the Royal Hawaiian Eye Meeting, Waikoloa Village, Hawaii, January 2002.
Received 24 June 2002; accepted 24 December 2002.
Abstract
Purpose
To evaluate factors related to the quality of vision after LASIK.
Design
Survey study.
Participants
One hundred consecutive patients.
Intervention
LASIK with a 6.0-mm elliptical ablation pattern without transition zone to treat mild to moderate myopia or astigmatism (preoperative manifest spherical equivalent [MSE], −4.79 ± 1.33 diopters [D]; range, −2.88 to −9.25 D). The second eye was treated 1 month after the first.
Main outcome measures
Completed questionnaires assessing night vision problems (glare, haze, and halo symptoms) before surgery and at 1, 3, and 6 months after surgery in 97, 75, 81, and 66 subjects, respectively. Mesopic pupil size and preoperative and postoperative variables were analyzed with questionnaire data using an analysis of variance (ANOVA) and multivariate regression analysis.
Results
Patients with large mesopic pupils had significantly more reports of glare, haze, and halo than did those with smaller pupils in the treated eye at 1 month after surgery (P=0.02, P=0.03, and P=0.02, respectively ANOVA) and of glare at 3 months (P=0.05). Significant predictors of symptoms at 6 months, identified through multivariate regression analysis, included preoperative MSE (for glare and haze), preoperative contrast acuity (glare), postoperative uncorrected visual acuity (UCVA; haze), and residual cylinder (haze). Together, these factors accounted for only 19% of the overall variability in glare and 37% of the variability in haze responses. No relationship between pupils and symptoms was noted at 6 months after surgery in either the ANOVA or regression analysis group.
Conclusions
Patients with large pupils had more quality of vision symptoms in the early postoperative period, but no correlation was observed 6 months after surgery. Factors related to long-term symptoms include the level of treatment (preoperative myopia), preoperative contrast acuity, postoperative UCVA, and residual cylinder. Most of the variability in visual quality could not be explained by preoperative or clinical outcome measures, including pupil size.
Supported by a grant from the Office of Naval Research, Bethesda, Maryland, and by U.S. Naval Aviation, Washington, DC. The Chief, Bureau of Medicine and Surgery, Navy Department, Washington, DC, Clinical Investigation Program sponsored this report (no. CIP S-99-016) as required by NSHSBETHINST 6000.41A. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.
The authors have no financial interest related to this work.
ABSTRACT