INDIANAPOLIS – Preliminary results comparing satisfaction with LASIK surgery and corneal contact lens wear over a 3-year follow-up period show that both methods of correcting refractive error have high satisfaction levels and are well accepted by a wide range of patients.
For those patients who had worn corneal contact lenses or frames, visual problems such as difficulty driving at night were rare after LASIK. However, some patients experience varying degrees of dry eye symptoms.
Dr. Price, of Indianapolis, Indiana, presented preliminary results 1 year after surgery to the Cornea Research Foundation of America (CRFA) from his personal clinical practice. The study was a joint nationwide multicenter survey and included three international centers in Spain, Singapore, and Brazil in an Internet-based, active-fill, prospective study with two aspects: LASIK surgery and corneal contact lenses.
In the LASIK surgery group, patients were evaluated preoperatively, and at 1, 2, and 3 years postoperatively. In the corneal contact lens group, patients were evaluated before wear, and 1, 2 and 3 years after wear, Dr. Price said.
The study included 1,899 patients, and at the 1-year follow-up time point, 356 patients who wore corneal contact lenses, 448 patients who had worn corneal contact lenses had LASIK surgery, and 154 patients who wore frames had LASIK surgery, for a 66% response rate. He said.
Content of the questionnaire
One of the questions asked patients if they would recommend LASIK or corneal contact lenses to a friend or family member. All patients said they were very willing, and LASIK surgery was preferred over corneal contact lenses. Of these patients, 77% of those who had worn frames had LASIK and 87% of those who wore corneal contact lenses had LASIK, so they were more likely to recommend LASIK to a friend, and 53% of those who wore corneal contact lenses were more likely to recommend corneal contact lenses to a friend. The difference between the two was statistically significant (p<0.001).
Another question was, at this time, do you feel more comfortable performing LASIK than wearing corneal contact lenses? The survey was conducted among patients who had worn corneal contact lenses and then had LASIK surgery. 83% of patients strongly agreed and 13% agreed that LASIK surgery felt better than wearing corneal contact lenses.
Nighttime Driving
Another survey question tested how difficult it was for patients to drive at night, and the results were very interesting. The preoperative rate of unimpeded night driving was 39% for patients who had worn frames, and this rate increased to 54% 1 year after LASIK.
For those patients who initially wore corneal contact lenses, 41% had unimpeded nighttime driving before surgery, rising to 62% 1 year after LASIK. For those patients who persisted in wearing corneal contacts, the nighttime driving rate remained essentially unchanged at 38% and 41% before and 1 year after wear, respectively.
Those who complained of serious problems with nighttime driving had lower rates, with equal proportions among the three groups, Dr. Price noted, but he was particularly surprised that nighttime driving was so difficult for those who wore frames prior to LASIK surgery.
”Overall, LASIK surgery significantly improved nighttime driving,” he said.
Another issue was the frequency of feeling dry eye in the first few weeks, and the results showed that among patients who had never had dry eye symptoms, those who previously wore frames and then had LASIK had a dramatic decrease in dry eye free symptoms, from 45 percent before surgery to 26 percent 1 year after LASIK.
In those patients who wore corneal contact lenses prior to LASIK, the difference in dry eye free rates was significantly smaller, at 54% and 40%, respectively. In those patients who were consistently fitted with corneal contact lenses, these rates did not change significantly at baseline and at 1 year (29% and 30%, respectively). The rate of patients with persistent dry eye symptoms increased mildly in all three groups.
Another issue was the frequency of daily use of artificial tears, which showed a significant decrease in the rate of patients who never used artificial tears, 76% at baseline and 37% 1 year after LASIK in patients who initially wore frames and then had LASIK, and 76% and 52%, respectively, in patients who initially wore corneal contact lenses and then had LASIK, and in patients who continued to wear For patients who continued to wear corneal contact lenses, the rates were 76% at baseline and 66% at 1 year. The difference between the groups was statistically significant (p<0.0001).
The rate of patients with severe dry eyes who had more than 5 artificial tear drops per day increased the most in the group who initially wore frames and then had LASIK. “The use of artificial tears will increase after LASIK,” Dr. Price said.
Benchmark for lasik
In this study, a large number of patients were selected from across the country and appropriate criteria were set for LASIK surgery, he said, as a way to compare two widely accepted methods of refractive error correction. both LASIK and corneal contact lenses have some risks, but offer more functionality and are more aesthetically pleasing than frame glasses.
“It’s worth noting that LASIK surgery improves night vision and improves night driving compared to corneal contact lenses and frames,” Dr. Price said, “but for all forms of vision correction, dry eye treatment needs to be considered. “