Einfluss der kornealen Biomechanik auf die Myopieregression nach Laser-in-situ-Keratomileusis

Abstract

Laser in situ keratomileusis is a safe and accepted method for correcting myopia. The operational results in terms of accuracy as well as the subjective acceptance of patients for corrections to - 8 D are now considered to be promising (Seiler, Refraktive Chirurgie der Hornhaut, 2000); however, postoperative results show individual patient problems in long-term stability. It is believed that the preoperative condition of the cornea (e.g. thickness, biomechanical properties) could have an influence on postoperative problems such as myopic regression. This study included a total of 46 eyes from 25 patients. At 3 months postoperatively, 15 patients (19 eyes) showed a SEQ of -0.50 D or more. Within this group, 11 patients (15 eyes) developed a regression (regression group) within the first 3 postoperative months. The remainder of the total group did not show any regression (stability group). The subjects of this study were on average 33 ± 8 years (stability group) and 31 ± 7 years old (regression group). The corneal thickness was tested and refractive error, visual acuity (BCVA/UCVA) and intraocular pressure was measured. In addition, the corneal hysteresis (CH) and corneal resistance factor (CRF) were determined. The mean preoperative spherical equivalent refraction was -3.14 D ± 1.41 D (SE) in the stability group and - 6.47 D ± 1.40 D (p = 0.001)in the regression group. Also, the postoperative spherical equivalents were statistically significant different (p < 0.05). In contrast, the mean preoperative corneal thickness showed no differences in both groups (p = 0.96) (stability group 563 ± 36 µm and regression group 563 ± 28 µm). The aim of the study to detect a possible causal relationship between myopia regression after LASIK and the biomechanical properties of the cornea and corneal thickness could not be clearly identified.