Laser refractive correction of myopia in visually impaired patients improves visual acuity.

Purpose: To retrospectively evaluate the visual and refractive outcome of visually impaired adults treated with refractive surgery (photorefractive keratectomy or laser-assisted in situ keratomileusis).

Methods: We searched a refractive surgery database comprising 1716 mildly visually impaired patients [best spectacle-corrected visual acuity (BSCVA) on a logMAR scale ≤ -0.1 (Snellen ≤ 0.8)] who had undergone either PRK or LASIK (n = 96). PRK patients who had visits at 5-7, 8-13 and 14-24 months postoperatively were selected. Eleven patients and nine PRK control myopic patients were found (cohort 1). From the same database, 41 visually impaired patients and 54 controls who had a postoperative control at 14-24 months postoperatively were chosen. These patients formed cohort 2.

Results: Preoperatively, in cohort 1, the mean BSCVA on a logMAR scale was -0.15 ± 0.13 (Snellen 0.73 ± 0.16) in visually impaired patients and 0.04 ± 0.02 (Snellen 1.11 ± 0.17) in myopic controls. At 14-24 months postoperatively, the mean BSCVA improved to 0.05 ± 0.04 (Snellen 1.13 ± 0.10) in visually impaired patients and 0.05 ± 0.08 (Snellen 1.13 ± 0.21) in control patients. In cohort 2, preoperatively the mean BSCVA on a logMAR scale was -0.15 ± 0.12 (Snellen 0.74 ± 0.14) in visually impaired patients and 0.01 ± 0.03 (Snellen 1.04 ± 0.10) in myopic controls. At 14-24 months postoperatively, the mean BSCVA improved to 0.02 ± 0.07 (Snellen 1.06 ± 0.16) in visually impaired patients and 0.06 ± 0.06 (Snellen 1.15 ± 0.16) in control patients.

Conclusion: Refractive surgery improves BSCVA in visually impaired patients, possibly through plastic changes in the visual cortex. Consequently, refractive surgery may be used successfully for the treatment of visually impaired adults to enhance their visual acuity.