Prospective, Randomized Comparison of Axial Elongation after LASIK versus Soft Contact Lens Wear in the Contralateral Eye.

PURPOSE: To evaluate whether LASIK induces axial elongation comparable to or less than that observed with continued soft contact lens (SCL) wear in myopic eyes.

DESIGN

A prospective, randomized-controlled within-person clinical trial.

PARTICIPANTS

Forty-two eyes from 21 patients (11 males, 10 females; mean age: 26 ± 4 years) with myopia or compound myopic astigmatism.

METHODS

In this contralateral-eye, randomized clinical trial, each participant underwent wavefront-guided (WFG) LASIK in 1 randomly assigned eye, while the fellow eye continued SCL wear. Axial length (AL), spherical equivalent (SE), higher-order aberrations (HOAs), visual acuity, and contrast sensitivity were assessed preoperatively and every 6 months for 2.5 years. The primary outcome was axial elongation from 6 months to 2.5 years postoperatively. Data were analyzed using linear mixed-effects models.

MAIN OUTCOME MEASURES: Axial elongation.

RESULTS

The mean preoperative SE in LASIK-treated eyes was -6.23 ± 1.95 diopters. In the early postoperative phase, a significant reduction in AL exceeding corneal thinning was observed, suggesting true axial shortening. From 6 months to 2.5 years, axial elongation did not significantly differ between the LASIK and SCL eyes. Although HOAs at a 6-mm pupil diameter increased more in LASIK-treated eyes, most participants reported subjectively superior visual quality in those eyes.

CONCLUSIONS

LASIK was associated with early axial shortening and did not accelerate long-term axial elongation compared with SCL wear. These results suggest a potential modulatory effect of WFG-LASIK on AL progression and support the need for further longitudinal studies.

FINANCIAL DISCLOSURES: The authors have no proprietary or commercial interest in any materials discussed in this article.