The surgical treatment of high myopia: comparison of epikeratoplasty, keratomileusis and minus power anterior chamber lenses.

Seventy high myopic eyes (-8.00 to -28.00 diopters) with epikeratoplasty (n = 29), myopic non-freeze keratomileusis (n = 26) or minus power anterior chamber intraocular lenses in phakic eyes (n = 15) were operated by two surgeons and were evaluated retrospectively. Results are reported at the 6-month postoperative interval. Eyes treated with epikeratoplasty had an average preoperative spherical equivalent of the cycloplegic refraction of -17.80 D (range -12.00 to -28.00 D). At 6 months, 66.6% of eyes were within 3 D of emmetropia and 7.4% of eyes had an uncorrected visual acuity of 20/40 or more. Average preoperative spectacle visual acuity was 20/50 (0.39); it was 20/50 (0.37) at both 6 and 24 months. Between 6 and 24 months, 32.2% of eyes had a change in refraction of 1.00 D or more. Two lenticules were removed. Eyes treated with non-freeze keratomileusis had an average preoperative refraction of -10.0 D (range -8 to -15 D). At 6 months, 61.5% of eyes were within 3.00 D of emmetropia and 30.7% of eyes had an uncorrected visual acuity of 20/40 or better. Average preoperative spectacle visual acuity was 20/30 (0.67), and 6 and 12 months afterward it was 20/30-20/40 (0.57) and 20/30 (0.66) respectively. Between 6 and 12 months, 8.3% of eyes, had a change in refraction of 1.00 D or more. Eyes treated with minus power anterior chamber lenses had an average preoperative refraction of -17.30 D (range -12.50 to -20.00 D).(ABSTRACT TRUNCATED AT 250 WORDS)