Hammond Stephen D, Puri Anil K, Ambati Balamurali K
Department of Ophthalmology, Medical College of Georgia, Augusta, Georgia, USA.
Curr Opin Ophthalmol. 2004 Aug;15(4):328-32. doi: 10.1097/00055735-200408000-00009.
The purpose of this article is to review the literature and find characteristics that lead to improved patient satisfaction and better quality of vision.
Flatter preoperative corneal curvature is a risk factor for starbursts after laser-assisted in situ keratomileusis (LASIK). Pupil size has not been found to be correlated with night vision symptoms. Wavefront-guided ablations reduce higher-order aberrations in comparison with traditional LASIK. Night vision symptoms are correlated with younger age, greater correction/increased ablation depth, enhancement, and decreased ablation diameter. Contrast sensitivity has been found to initially decrease after LASIK, returning to baseline 6 to 12 months postoperatively.
LASIK has quickly become the refractive procedure of choice around the world. Quality of vision and patient satisfaction after LASIK can be difficult to assess because of the many variables that must be considered to accurately measure these endpoints. Preoperative characteristics such as: increased patient age, decreased corneal toricity, or increased pupil size reduce patient satisfaction. Intraoperative factors like decentration, ablation-zone size, active eye tracking, and wavefront guided ablations affect quality of vision. Finally, postoperative factors such as night vision symptoms, reduced contrast sensitivity, and re-treatment can lead to a decline in patient satisfaction. Eliminating or limiting these variables may lead to increased patient satisfaction and higher quality of vision after LASIK.