[Bioptic. A refractive surgery procedure for correction of high and extreme myopia].

Background: The complete correction of highly or extremely myopic eyes to emmetropia can only be achieved by very few procedures: The combination of implanting phacic intraocular lenses and the use of LASIK (laser in-situ keratomileusis) - Bioptic - makes it possible to achieve this goal to a great extent.

Patients And Methods: The Bioptic procedure was carried out on 17 eyes of 10 patients. Two weeks after corneal dissection with the Hansatom,an implantable phacic lens (STAAR) was introduced into the posterior chamber and 4 weeks later the residual myopia was treated with LASIK combined with the correction of astigmatic errors. The follow-up time was 10.2 (6.7) months.

Results: Preoperative average values of the manifest refraction were -16.22 sph (3.86) with 1.40 cyl (1.30) which changed to -3.85 sph (2.73) with -1.50 cyl (0.87) after implantation of an ICL trade mark into the posterior chamber. Visual acuity increased from uncorrected hand motion to 0.13 (0.10) and corrected from 0.53 (0.19) to 0.63 (0.19). The refraction of implanted ICLs trade mark was 14.6 dpt (1.1). Following the LASIK procedure the uncorrected visual acuity improved to 0.68 (0.16) and fully corrected to 0.79 (0.20). The final refraction measured +0.16 sph (0.67) with -0.48 cyl (0.25). The keratectomy depth was 80.63 -m (26.9) and the optical zone showed a horizontal distance of 6.28 mm (0.39).

Conclusion: Bioptic is able to correct highly and extremely myopic eyes with the combination of phacic lenses and subsequent LASIK. A concomitant astigmatism can be corrected up to 2.5 dpt simultaneously. With the combination of both procedures,the optical zone can be enlarged. Keeping in mind that phacic lenses reveal a constant refraction after a few days and also that LASIK is refractively safe in low myopia of -4 dpt to -5 dpt, it can be expected that the refractive deviation following the Bioptic procedure is low.