Prospective comparison of single-zone and multizone laser in situ keratomileusis for the correction of low myopia

Abstract

Objective: This study aimed to determine whether there is a true difference in predictability between single-zone and multizone laser in situ keratomileusis (LASIK) for the correction of low myopia or whether any difference in predictability is because of a need for separate clinical nomograms for the two treatments.

Design: A prospective, randomized, clinical trial.

Participants: Fourteen surgeons and 190 eyes of 95 patients with myopia who desired surgical correction of myopia ranging from -2.00 to -7.00 diopters (D) participated.

Intervention: Fellow eyes of patients with myopia undergoing bilateral simultaneous LASIK were randomized to single-zone and multizone ablation. Astigmatism was not corrected at the time of LASIK.

Main outcome measures: Predictability, postoperative videokeratography, and contrast sensitivity were assessed at 3 months after surgery.

Results: At 3 months, r2 values relating laser setting to change in spherical equivalent refraction were 0.78 for single-zone and 0.76 for multizone ablation; mean outcome with respect to intended was -0.84 D (0.65 standard deviation [SD]) for single-zone and -0.62 D (0.78 SD) for multizone eyes (P = 0.035). There was no relationship between single-zone and multizone ablation and the likelihood of asymmetric postoperative videokeratography (P = 0.83). The only difference in contrast sensitivity was a significantly greater decrease in log contrast for multizone eyes at 12 cyc/deg under undilated conditions.

Conclusions: There is no true difference in predictability between single-zone and multizone LASIK for the correction of low myopia. Separate clinical nomograms for single-zone and multizone LASIK should eliminate the difference in predictability that was observed in this clinical trial.