Myopic Keratomileusis: Early Experience

Abstract

An evaluation of the first consecutive 23 myopic keratomileusis (MKM) procedures of one of the authors is presented. The average preoperative myopia was -10.2 ± 3.24 diopters and the average postoperative myopia was +0.10 ±1.58 diopters. The average refractive change was -10.09 diopters. Comparing the desired refractive result to the achieved result shows a mean correction of 100.7%. Thirteen of 23 eyes (57%) were within +1.0 diopters of emmetropia and 20 of 23 eyes (87%) were within ±2.0 diopters of emmetropia. The average preoperative cylinder measured 1.13 diopters and the average postoperative cylinder was 1.38 diopters. A success rate defined as uncorrected acuity of 20/50 or better was achieved in 85% of the patients during the time course of this study. Visual recovery was rapid. The high success rate and predictabilty is accounted for by improvements in the cryolathe, such as digital readouts and change in the cutting tool configuration, and improvements in the computer program. Guidance from an experienced cryolathe surgeon was also invaluable. With meticulous attention to detail, particularly with the microkeratectomy, and if an ophthalmic microsurgeon is willing to make a significant commitment to learning the technique, myopic keratomileusis can effectively correct moderate to high degrees of myopia.