Long-Term Quality of Life after Myopic Laser Refractive Surgery

Se Kyung Kim; Jae Hoon Kim; Eung Kweon Kim; Kyung Sun Na; Hungwon Tchah; Joon Young Hyon; Eun Young Cho; Sun Young Jung; Eun Jin Jang; Tae Im Kim

doi:10.3341/jkos.2011.52.8.922

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Kim, Kim, Kim, Na, Tchah, Hyon, Cho, Jung, Jang, and Kim: Long-Term Quality of Life after Myopic Laser Refractive Surgery

Original Article

J Korean Ophthalmol Soc 2011;52(8):922-929.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.8.922

Long-Term Quality of Life after Myopic Laser Refractive Surgery

Se Kyung Kim, MD¹, Jae Hoon Kim, MD¹, Eung Kweon Kim, MD, PhD¹, Kyung Sun Na, MD², Hungwon Tchah, MD³, Joon Young Hyon, MD⁴, Eun Young Cho, MD⁵, Sun Young Jung, PhD⁶, Eun Jin Jang, PhD⁶, Tae Im Kim, MD, PhD¹

¹The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

²Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Seoul, Korea

³Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Korea

⁴Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

⁵BS Eye Center, Seoul, Korea

⁶National Evidence-based Healthcare Collaborating Agency, Seoul, Korea

Address reprint requests to Tae Im Kim, MD, PhD Department of Ophthalmology, Yonsei University Severance Hospital #134 Sinchon-dong, Seodaemun-gu, Seoul 120-752, Korea Tel: 82-2-2228-3570, Fax: 82-2-312-0541, E-mail: tikim@yuhs.ac

Received 6 January 2011 Revised 16 February 2011 Accepted 6 May 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate long-term satisfaction and quality of life after myopic laser refractive surgery.

Methods

This study included 231 myopic patients who underwent laser refractive surgery (LASIK, LASEK or PRK) at least five years prior, between 2002 and 2005, at 5 hospitals. Using a telephone survey, patients were asked to subjectively answer 26 questions regarding satisfaction, quality of life changes, and visual symptoms.

Results

The mean patient satisfaction score was 8.12 (scale of 1 to 10). Improvement in quality of life was reported by 91% of the subjects. Intention to have surgery again was reported by 87.9% of the subjects and intention to recommend refractive surgery to a friend or family was reported by 80.5% of the subjects. The most common discomfort symptoms after myopic laser refractive surgery were dry eye symptoms (57.1%), followed by night vision disturbances (54.3%).

Conclusions

Long-term satisfaction and quality of life were shown to be positive in patients treated with myopic refractive surgery.

Keywords: Laser refractive surgery, Long-term satisfaction, Quality of life

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Figure 1.

Intention of receiving myopic laser refractive surgery again.

Figure 2.

Recommend myopic laser refractive surgery to a friend or family.

Figure 3.

Satisfaction about psychological well-being after myopic laser refractive surgery.

Figure 4.

Visual discomfort after myopic laser refractive surgery.

Table 1.

Patient demographics

		Mean ± SD^*	N (%)
Sex	Male		42 (18.2)
	Female		189 (81.8)
Age at survey (yr)		35.7 ± 5.91	
	20–29		28 (12.2)
	30–39		149 (64.5)
	40–49		47 (20.3)
	50–59		7 (3.0)
Age at operation (yr)		29.4 ± 5.70	
	20–29		133 (57.6)
	30–39		86 (37.2)
	40–49		12 (5.2)
Type of surgery			
	LASIK in both eyes		152 (65.7)
	LASEK or PRK in both eyes		66 (28.6)
	LASIK in one eye		8 (3.5)
	LASEK or PRK in one eye		5 (2.2)
Preoperative refractive error (SE^†) ^‡		−5.0 ± 1.9	
	<-6.0D		164 (71.0)
	≥ −6.0D		67 (29.0)
Elapsed time after surgery (yr)		6.3 ± 1.11	
	5≤ and ＜6		71 (30.7)
	6≤ and ＜7		72 (31.2)
	7≤ and ＜8		41 (17.8)
	8≤ and ＜9		47 (20.3)

^* SD = standard deviation

^† SE = spherical equivalent

^‡ Based on more myopic eye between both eyes.

Table 2.

Patient satisfaction after myopic laser refractive surgery

		Patient satisfaction score (mean ± SD^*)	p-value^†
Overall		8.12 ± 1.77	
Sex			0.09
	Male	7.56 ± 2.38	
	Female	8.25 ± 1.60	
Age at operation (yr)			0.06
	20–29	7.86 ± 1.85	
	30–39	8.49 ± 1.65	
	40–49	8.42 ± 1.32	
Type of surgery			0.83
	LASIK	8.13 ± 1.73	
	LASEK or PRK	8.10 ± 1.88	
Preoperative refractive error (SE^‡) (worse eye)			0.01
	＜-6.0D	8.31 ± 1.09	
	≥ −6.0D	7.62 ± 1.89	

^* SD = standard deviation

^† p-value by t-test; ANOVA test

^‡ SE = spherical equivalent.

Table 3.

Comparison of visual discomfort after myopic laser refractive surgery

	Preop.^* SE^† <-6.0D (n = 164) N (%)	Preop.^* SE^† ≥-6.0D (n = 67) N (%)	p-value
Double vision	35 (21.3)	32 (47.8)	<0.001
Halo	47 (28.7)	23 (34.3)	0.43
Glare	65 (39.6)	36 (53.7)	0.06
Night blurring	87 (53.0)	41 (61.2)	0.24
Blurred vision	38 (23.2)	24 (35.8)	0.07
Redness, pain	58 (35.4)	30 (44.8)	0.23
Dryness	87 (53.0)	44 (65.7)	0.11
Eye discharge	43 (26.2)	25 (37.3)	0.11
Color distinction	1 (0.6)	2 (3.0)	0.21
Eye soreness	57 (34.8)	31 (46.3)	0.14
At least one of these symptoms	138 (84.1)	63 (94.0)	0.05

^* Preop. = preoperative

^† SE = spherical equivalent.

Table 4.

Comparison of visual discomfort after myopic laser refractive surgery

	LASIK (n = 160) N (%)	LASEK or PRK (n = 71) N (%)	p-value
Dryness			
Yes	88 (55%)	43 (60.6%)	0.80
Night blurring			
Yes	97 (60.6%)	31 (43.7%)	0.11

Table 5.

Spearman correlation coefficients between visual discomfort and pupil size

	Night blurring	p-value	Halo	p-value
Pupil diameter^*	0.111	0.26	−0.057	0.56
Pupil diameter^*-ablation zone size	0.103	0.13	−0.027	0.70

^* Mesopic pupil diameter.

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