Long Term Safety Results of LASIK Refractive Surgery: A Twenty-Year Retrospective Study

Purpose: To evaluate the 20-year safety, efficacy, and satisfaction of LASIK patients treated between 1997 and 2002. Setting: Private Practice Design: Randomized Retrospective Study Methods: A sample of patients who underwent LASIK between 1997 and 2002 was randomly selected during annual follow-up examinations. Study compared pre-operative refractive error and corrected distance visual acuity (CDVA) with measurements at most recent follow-up. Participants completed satisfaction questionnaires at last visit. Retreatments were performed when determined appropriate by both doctor and patient. Results: 238 patients (468 eyes) had an initial average manifest refraction of -5.16 ±2.86 D sphere (median, -4.75 D) and -0.88 ±0.94 D cylinder (median, -0.75 D). Average manifest refraction at most recent follow-up was -0.33 ±1.08 D sphere (median, 0.00 D) and -0.47 ±0.45 D cylinder (median, -0.50 D). 92.1% of eyes achieved 20/20 or better CDVA at recent follow-up compared to 86.7% achieving 20/20 or better CDVA pre-operatively. 97.4% of participants reported satisfaction with having LASIK. Common problems included distance blur (4.7%), eye dryness (2.0%), and glare/halos (1.3%). All participants reported greater independence from glasses and greater convenience in daily life. Retreatment rate across 22 years was 31.2%. Conclusions: : After over 20 years post-treatment, LASIK refractive surgery was shown to be highly effective with a high level of safety and satisfaction. Mean CDVA was higher after 20 years post-LASIK than prior to surgery. Retreatments were commonly provided to maintain good unaided distance acuity. Overall, potential long-lasting negative side effects of LASIK, such as dryness and halos, were relatively rare.