Progression of Myopic Maculopathy: A Systematic Review and Meta-Analysis.

PURPOSE: The purpose of this study was to elucidate the risk factors for the progression of myopic maculopathy (MM) based on severity. METHODS: In this study, we conducted a systematic review and meta-analysis of the literature published before December 2020 on the risk factors for the progression of MM in patients with pathologic myopia (PM) and high myopia (HM). Odds ratios (ORs) for different stages of myopic maculopathy categorized based on the International Meta-Analysis for PM (META-PM) classification were calculated using fixed and random effects models. RESULTS: A total of 12,070 affected eyes derived from 5 cohort studies were included in the systematic review. The presence of PM at baseline was found to be significantly associated with an increased risk of MM progression (pooled ORs: 7.17, 95% confidence interval [CI]: 3.29-15.6), and the greater category of MM at baseline was found to be significantly associated with an increased risk of MM progression, that is, eyes with MM category 3 or more compared with eyes with MM category 2 (pooled OR: 10.95, 95% CI: 6.07-19.76) and eyes with MM category 4 compared with eyes with MM category 3 (pooled ORs: 2.45, 95% CI: 0.28-21.37). CONCLUSIONS: The findings in this systematic review and meta-analysis indicate that the progression of MM is associated with more severe MM at baseline.

[Patient-reported Outcomes after Laser In Situ Keratomileusis Surgery].

PURPOSE: To evaluate patient-reported quality of vision before and after laser in situ keratomileusis (LASIK) surgery. SUBJECTS AND METHODS: This study involved 140 patients who underwent LASIK surgery at Baptist Eye Clinic, Kyoto, Japan. Each patient was asked to respond to the Refractive Status and Vision Profile (RSVP) questionnaire prior to surgery and at 6-months and 5.5-years postoperative. In each patient, we defined the eye with better uncorrected visual acuity (VA) or with less refractive error as the better eye, and the other eye as the worse eye. RESULTS: Even in the worse eyes, the percentage of eyes with an uncorrected VA of decimal 0.5 or greater was 93.5% at 6-months and 88.6% at 5.5-ears postoperative. The mean preoperative total RSVP score was 37.1, yet that score significantly improved at 6-months postoperative (p< 0 .001) and remained the same throughout the 5.5-year follow-up period. CCONCLUSION The patient-reported quality of vi-ion post LASIK surgery was improved and remained improved throughout the 5.5-year follow-up period.

Comparative Study of Seven-year Outcomes Following Laser In Situ Keratomileusis with those of Trans-epithelial Photorefractive Keratectomy.

Purpose: To compare the long-term outcomes of laser-assisted in situ keratomileusis (LASIK) and trans-epithelial photorefractive keratectomy (tPRK). Methods: In this retrospective study, 23 eyes of LASIK patients were compared with 23 eyes of patients who underwent tPRK; none of who underwent retreatment. The cases were matched for refractive power and patient age. In all patients, visual acuity (VA), refractive power and corneal topography were evaluated between 6-months and 7-years postoperative. Results: At 7-years postoperative, uncorrected VA was 20/20 or better in 71.9% of the LASIK-treated eyes and in 68.7% of the tPRK-treated eyes. From 6-months to 7-years postoperative, both the LASIK- and tPRK-treated eyes developed a slight myopia (-0.18 D and -0.36 D, p=0.24), and a difference in corneal power change was observed between the LASIK (0.23 D steeper) and tPRK (0.57 D steeper) (p=0.05) eyes. Conclusion: At 7-years postoperative, a good surgical outcome was found in both the LASIK- and tPRK-treated eyes, yet myopic regression was more pronounced in the tPRK-treated eyes than in the LASIK-treated eyes.

Microincision Hydrophobic Acrylic Aspheric Toric Intraocular Lens for Astigmatism and Cataract Correction.

PURPOSE: To evaluate the efficacy and safety of a new acrylic one-piece toric intraocular lens (IOL). METHODS: This prospective multicenter clinical trial included 93 eyes of 61 patients that were implanted with a hydrophobic acrylic toric IOL from 2010 to 2012 and followed for 1 year. This IOL uses the platform of a microincision one-piece aspheric IOL, the NY-60 IOL (HOYA, Tokyo, Japan), with three increments in cylindrical power (NHT15, 1.5 diopters [D]; NHT23, 2.25 D; and NHT30, 3.0 D). The inclusion criterion was preoperative corneal astigmatism from 0.75 to 3.00 D. The primary endpoint was uncorrected distance visual acuity (UDVA) of 0.0 logMAR (20/20 Snellen) or better 6 months postoperatively. In addition to UDVA, corrected distance visual acuity (CDVA), residual astigmatism, stability of the IOL alignment, need of realignment, and the rate of Nd:YAG laser capsulotomy were evaluated up to 1 year postoperatively. Errors in astigmatic correction were assessed using Alpin's vector analysis. RESULTS: The primary endpoint was achieved in 54.8% of eyes. One year postoperatively, the logMAR UDVAs were 0.02 ± 0.13, 0.05 ± 0.17, and 0.09 ± 0.14 with models NHT15, NHT23, and NHT30, which corresponds to 0.96 (19/20 Snellen), 0.89 (18/20 Snellen), and 0.82 (16/20 Snellen), respectively. One year postoperatively, the residual astigmatism was 0.66 ± 0.58 D. In each evaluation, the mean absolute change in the position of the axis mark was between 1.93° and 2.32°. Three eyes required repositioning of the IOL axis and 2 eyes received Nd:YAG laser capsulotomy. The correction error showed an undercorrection with against-the-rule astigmatism and overcorrection with with-the-rule astigmatism. CONCLUSIONS: The new one-piece toric IOL provided desirable clinical outcomes and stability in eyes with corneal astigmatism.

[Infection post Excimer Laser Corneal Refractive Surgery].

PURPOSE: To report the cases with severe infection post excimer laser refractive surgery. METHODS: This study involved 6 eyes of 4 women (mean age 38 years, range : 27-51 years) who underwent excimer laser corneal refractive surgery. RESULTS: In all 4 cases, the respective primary causative organisms of the infection were quinolone-resistant methicillin-sensitive Staphylococcus aureus, quinolone-resistant methicillin-resistant Staphylococcus aureus, yeast type fungus, and in 1 case, penicillin-resistant Streptococcus pneumoniae. We initiated topical antibiotics or intensive antifungal treatment, yet due to severe inflammation and ophthalmalgia, analgesic drugs were needed. An average hospitalization period was 38.5 days (range : 22-77 days), and the best spectacle-corrected visual acuity was 0.5 or more than 0.5 post discharge. CONCLUSIONS: In the treatment of severe corneal infection post refractive surgery, it is important to identify the primary causative organism. If the response to the initial treatment is poor, such patients should immediately be referred to a special clinic to obtain a better visual outcome.

Identification and Analysis of Primary Cilia in the Corneal Endothelial Cells of Patients with Bullous Keratopathy.

PURPOSE: To identify primary cilia in human corneal endothelial cells (CECs) obtained from patients with bullous keratopathy (BK). METHODS: This study involved CEC specimens obtained from 10 eyes of 10 consecutive patients (three males and seven females; mean age: 74.5 years, range: 68-90 years) with BK who underwent Descemet's stripping automated endothelial keratoplasty at Baptist Eye Institute, Kyoto, Japan between August 2019 and September 2020. Three corneal buttons obtained from 3 patients who underwent penetrating keratoplasty for keratoconus were used as 'non-BK' controls. All specimens were evaluated with immunofluorescence staining using an antibody against acetylated α-tubulin. RESULTS: Ciliary expression was observed in six of the 10 CEC specimens; i.e. in two specimens obtained from BK patients after glaucoma surgery (trabeculectomy), in two specimens obtained from patients with Fuchs endothelial corneal dystrophy, and in two specimens obtained from a patient with BK after laser iridotomy for primary angle closure. There was acetylated α-tubulin staining but no hair-like structures in two specimens, and ciliary expression was unknown in two specimens due to the absence of cells. The length of the primary cilia varied between all specimens. In contrast, no primary cilia were observed in the corneal buttons obtained from the three keratoconus patients. CONCLUSION: The findings in this study clearly demonstrate the expression of primary cilia in the CECs of patients afflicted with BK.

Corneal Electrolysis for Granular Corneal Dystrophy Type 2 (Avellino Corneal Dystrophy) Exacerbation After LASIK.

PURPOSE: To report two cases in which exacerbation of granular corneal dystrophy type 2 (GCD2; Avellino corneal dystrophy) after laser in situ keratomileusis (LASIK) was successfully removed by corneal electrolysis. METHODS: This study involved a 66-year-old man and a 43-year-old man with GCD2 who had undergone bilateral LASIK for myopia 10 or more years prior to presentation. In both patients, GCD2 corneal opacity gradually developed postoperatively at the LASIK flap interface, thus resulting in a decrease of visual acuity. For treatment, the LASIK flaps in both patients were surgically lifted to directly remove the opacity. Corneal electrolysis was then applied to the back of each LASIK flap and stromal bed. RESULTS: Postoperatively, the ocular symptoms and corneal opacities related to GCD exacerbation disappeared, with improvement of corrected and uncorrected distance visual acuity and almost no change of refractive error. CONCLUSIONS: The findings reveal that corneal electrolysis is safe and effective for treating exacerbations of GCD2 following LASIK when applied to a surgically lifted flap, and that it successfully removes GCD2-related LASIK flap interface opacities with almost no change of refractive error postoperatively. [J Refract Surg. 2023;39(1):61-65.].

Assessment of myopic rebound effect after discontinuation of treatment with 0.01% atropine eye drops in Japanese school-age children.

PURPOSE: Having previously demonstrated the efficacy of 0.01% atropine eye drops for inhibiting progression of childhood myopia, we conducted additional analyses to assess post-treatment changes in myopia progression. STUDY DESIGN: Analysis of follow-up data from a previously reported randomized controlled trial METHODS: A mixed-effects model was used to compare intergroup changes in spherical equivalent (SE) and axial length (AL) at 1 month and 12 months after discontinuation of 2-year treatment with atropine or placebo in 167 school-age children. RESULTS: Follow-up measurements were available for 149 participants at 1 month after discontinuation of treatment and for 51 participants at 12 months after discontinuation. At 1 month post-treatment, differences between the atropine and placebo groups in least squares (LS) mean changes in SE and AL, respectively, from 24 months were -0.06 diopters (D) (95% CI: -0.21, 0.08; P = .39) and 0.02 mm (95% CI: -0.05, 0.08; P = .60). At 12 months post-treatment, intergroup differences (atropine vs placebo) in LS mean changes in SE and AL, respectively, were -0.13 D (95% CI: -0.35, 0.10; P = .26) and -0.02 mm (95% CI: -0.12, 0.09; P = .75). LS mean changes in SE and AL from treatment discontinuation did not differ between the groups at 1 or 12 months post-treatment. CONCLUSION: Axial elongation was significantly less in the atropine group than in the placebo group. The suppression effect obtained at 2 years was maintained after 12 months. The absence of intergroup differences in myopia progression since treatment cessation suggests that myopic rebound did not occur.

Clinical presentations of acquired comitant esotropia in 5-35 years old Japanese and digital device usage: a multicenter registry data analysis study.

PURPOSE: To describe clinical presentations of acquired comitant esotropia and digital device use in children, adolescents, and young adults without neurological problems. STUDY DESIGN: Multicenter prospective observational study. METHODS: Patients with acquired comitant esotropia, without intracranial diseases aged 5-35 years at the time of visit, who were seen at pre-registered facilities within 1 year of onset were enrolled. The duration from the onset of symptoms and the time of digital device usage approximately 1 month before onset and their lifestyles were surveyed. Visual acuity, cycloplegic refraction, and strabismus angles were measured. Data were analyzed in three age groups (Child: 5-12 years, Adolescent: 13-18 years, and Young adult: 19-35 years). RESULTS: Between November 2019 and December 2021, 218 patients were enrolled from 55 facilities, and 194 patients (including 62 children, 69 adolescents, and 63 young adults) were analyzed. The child group spent the least amount of time using digital devices (children: 159; adolescents: 210; young adults: 267 min/work day, p < 0.05; (mean time in the same order below) 229, 338, 314 min/holiday, p < 0.05) and had the largest strabismus angle (mean strabismus angle at near: 30, 22, 18 PD, p < 0.01; at far: 28, 26, 21 PD, p<0.05). CONCLUSION: The clinical features of acquired comitant esotropia and hand-held digital device usage differed between children aged ≤ 12 years and older patients. This report gives the current clinical characteristics of young patients with acquired esotropia and digital device usage.

Comparison of penetrating keratoplasty outcomes with or without microwave thermokeratoplasty.

Microwave thermokeratoplasty (MTK) is a surgical procedure for the correction of pathologic corneal steepening. The purpose of this study was to examine the postoperative outcomes of eyes with advanced keratoconus that underwent femtosecond-laser zig-zag penetrating keratoplasty (z-PK) following MTK for reshaping of the central cornea. This study involved 32 eyes of 32 consecutive advanced keratoconus patients; i.e., 25 eyes of 25 patients who underwent MTK prior to z-PK (MTK + z-PK group), and 7 eyes of 7 patients who underwent z-PK alone (z-PK group). In all treated eyes, visual acuity (VA) and corneal topography were measured before surgery and at 6-months postoperative. At 6-months postoperative, the mean uncorrected distance VA (logarithm of the minimum angle of resolution) and surface regularity index (SRI) of the MTK + z-PK group was 0.62 ± 0.39 (mean ± standard deviation) and 1.26 ± 0.45, respectively, while that in the z-PK group was 1.02 ± 0.18 and 7.64 ± 3.22, respectively. Both variables were significantly better in the MTK + z-PK group than in the z-PK group (P < 0.05). The findings in this study reveal that MTK prior to z-PKP is effective for improving UDVA and reducing the irregularity of corneal topography in patients with advanced keratoconus.

Surgical outcomes of re-excimer laser phototherapeutic keratectomy (re-PTK).

To assess the surgical outcomes of re-excimer laser phototherapeutic keratectomy (re-PTK) for recurrent disease after initial PTK. Retrospective cohort study with historical comparison group. This study involved 56 patients who underwent re-PTK (mean follow-up period: 47.9 ± 36.2 months) at the Baptist Eye Institute, Kyoto, Japan. In all subjects, corrected-distance visual acuity (CDVA) before and after re-PTK was compared. Postoperative recurrence of corneal lesion with a decrease of CDVA of two lines or more was compared with postoperative best CDVA deemed as a significant relapse. The Kaplan-Meier method was used to compare the recurrence rate post-re-PTK with that after the initial PTK. The disease classification in the 78 eyes was heterozygous-type GCD (hetero-GCD, n = 47 eyes), homozygous-type GCD (homo-GCD, n = 13 eyes), band keratopathy (n = 7 eyes), lattice corneal dystrophy (n = 6 eyes), and other (n = 5 eyes). After re-PTK, homo-GCD recurred statistically significantly earlier than hetero-GCD (P = 0.0042). No significant difference was found in the recurrence rate for all diseases between post-re-PTK and post initial PTK (P > 0.05). Surgical outcomes after re-PTK were nearly equal to those after initial-PTK.

Comparison of myopia progression between children wearing three types of orthokeratology lenses and children wearing single-vision spectacles.

PURPOSE: To evaluate factors related to myopia progression in children wearing either orthokeratology (OK) lenses or single-vision spectacles (SVS) for 2 years. STUDY DESIGN: Pooled-analysis retrospective intervention study. METHODS: This study involved 105 school-aged children wearing SVS who participated in the multi-center Myovision Study and 89 school-aged children wearing one of 3 OK lens types [Menicon Z Night (M, n = 27), αORTHO®-K (A, n = 32), and Emerald™ (E, n = 30)]. In the OK-lens patients, last examination was performed at ≥ 3-weeks post lens-wear discontinuation. Of the subjects, 102 SVS-Group and 79 OK-Group (M: n = 24, A: n = 28, and E: n = 27) children completed all examinations. A relationship between refractive error (RE) change and 7 factors (correction methods, baseline age, baseline RE, baseline axial length, gender, right or left eye, and follow-up period) was derived by multiple regression modeling. Via those same methods, we investigated the relationship between RE change and 7 factors including 3 OK-lens corrections. RESULTS: Related influence factors were correction method (0.85 D myopia reduction in the OK Group, P < 0.001), baseline age (0.16 D myopia reduction in older-age patients, P < 0.001), and baseline RE (0.12 D myopia reduction per 1 D myopia, P = 0.01). No relationship was found between RE change and OK-lens type. No serious adverse events occurred. CONCLUSION: Regardless of OK lens design, myopia progression in school-aged children was suppressed. The effect was examined not only via axial-length elongation but also RE change, and the myopia control effect by OK lenses was found to be 0.85 D over the 2-year period.

Clinical study on the effect of multifocal contact lenses on myopia progression in myopia school children : Multifocal contact lens study for suppression of myopia progression.

BACKGROUND: The efficacy of peripheral low add multifocal soft contact lenses (SCLs) for suppressing the progression of myopia is controversial. The aim of the on-going present clinical study is to investigate whether or not multifocal SCLs with + 0.50 diopters (D) addition suppress the progression of myopia in myopic elementary school children. DESIGN: Prospective randomized controlled trial. SUBJECTS AND METHODS: The study plans to include a total of 100 myopic school children. Target subjects are primary school male and female students with mild to moderate myopia. Children who have eye-related diseases other than myopia are excluded from the study, because they may affect the evaluation of the outcome. Subjects will be randomly assigned to wear daily disposable multifocal contact lenses with + 0.50D addition or daily disposable SCLs. Subjects will wear contact lenses on both eyes and will be observed for 2 years under a double-masked examination. Primary outcome is a change in the axial length over the 2-year period. OBJECTIVES: The purpose of this study is to identify whether or not multifocal SCLs with + 0.5D addition suppress the progression of myopia in myopic elementary school children as compared with standard SCLs. TRIAL REGISTRATION: 1. UMIN (University Hospital Medical Information Network) UMIN000027940. Registered on July 21, 2017 2. JRCT (Japan Registry of Clinical Trials) jRCTs052180172. Registered on March 26, 2019.

Corneal Cross-Linking for Paediatric Keratoconus: A Systematic Review and Meta-Analysis.

All corneal cross-linking techniques attenuated disease progression in patients with pediatric keratoconus for at least one year based on a meta-analysis. A standard and accelerated technique led to marked improvement in visual acuity. We determined the efficacy and safety of corneal cross-linking (CXL) in pediatric keratoconus by conducting a systematic review and meta-analysis. The PubMed and Cochrane databases were searched for relevant studies on the effects of standard, transepithelial, and/or accelerated CXL protocols in patients aged 18 years or younger. Standardized mean differences with 95% confidence intervals were calculated to compare the data collected at baseline and 12 months. The primary outcomes were maximum keratometry (Kmax) and uncorrected visual acuity (UCVA), and the secondary outcomes were the thinnest corneal thickness (TCT), best-corrected visual acuity (BCVA), and manifest refraction spherical equivalent or cylindrical refraction. Our search yielded 7913 publications, of which 26 were included in our systematic review and 21 were included in the meta-analysis. Standard CXL significantly improved the Kmax, UCVA, and BCVA, and significantly decreased the TCT. Accelerated CXL significantly improved UCVA and BCVA. In the transepithelial and accelerated-transepithelial CXL methods, each measurable parameter did not change after treatments. All CXL techniques attenuated disease progression in patients with pediatric keratoconus for at least one year. Standard and accelerated CXL led to marked improvement in visual acuity.

Accuracy of the Barrett Universal II formula integrated into a commercially available optical biometer when using a preloaded single-piece intraocular lens.

PURPOSE: To compare the commonly used formulas for intraocular lens (IOL) selection using IOLMaster®700 (Carl Zeiss Meditec) and to evaluate the Barrett Universal II (BU-II) formula accuracy when using the Vivinex™ iSert® XY1 IOL (Hoya Corporation Medical Division). METHODS: A retrospective chart review was performed that included patients who underwent uneventful cataract surgery with in-the-bag insertion of Vivinex™ iSert® XY1 IOL. Prediction errors at 3 months postoperative of IOLMaster® 700 with Haigis, Holladay 1, SRK/T, and BU-II formulas were compared. As a subgroup analysis, we focused on the axial length (AL) and IOL power. AL subgroup analysis was based on the following AL subgroups: short (<22.5 mm), medium (22.5-25.5 mm), and long (>25.5 mm). IOL power subgroup analysis was based on the following IOL power subgroups: low (≤18.0 diopters [D]), medium (18.5-24.0 D), and high (≥24.5 D). RESULTS: This study included 590 eyes of 590 patients. Overall, the four IOL calculation formulas appeared to be similarly accurate. In the long AL subgroup, the BU-II formula had a significantly lower absolute error (AE) than the Holladay 1 formula. In the low-power subgroup, the BU-II formula had a significantly lower AE than the Holladay 1 and SRK/T formulas. On the other hand, in the high-power subgroup, the BU-Ⅱ formula was significantly less accurate than the SRK/T formula and also appeared to be worse than the Holladay 1 formula (P = 0.052). CONCLUSION: The BU-II formula might be less accurate when using a Vivinex™ iSert® XY1 IOL of 24.5 D or greater.

A multicenter clinical trial of orthokeratology in school-aged children and adolescents in Japan.

PURPOSE: This study investigated the safety and efficacy of orthokeratology in myopic children in Japan. STUDY DESIGN: Prospective clinical trial. METHODS: This study enrolled myopic children aged 6-16 years with a spherical equivalent of -1.00 D to -4.00 D and astigmatism of -1.5 D or lower, whose parents could manage contact lens use and could provide written informed consent. The children were treated with orthokeratology lenses (BREATH-O CORRECT R, Universal View Co., Ltd.) for 3 years. Slit-lamp findings, visual acuity, intraocular pressure, subjective refraction, corneal topography, corneal endothelial cell density, corneal thickness, and axial length were regularly assessed. RESULTS: This study included 96 eyes of 48 patients (average age, 10.7 ± 2.08 years). The average baseline spherical equivalent was -2.46 ± 0.97 D. The average baseline uncorrected visual acuity was 0.74 ± 0.32 logMAR, with significant improvement to -0.08 ± 0.18 logMAR at 4 weeks and 0.02 ± 0.21 logMAR at 3 years (both p < 0.001, Dunnett's test). The average baseline corneal endothelial cell density was 3053 ± 181 cells/mm2 and 3028 ± 213 cells/mm2 at postoperative 3 years (p = 0.9933, Dunnett's test). The average axial length was 24.70 ± 0.78 mm at baseline, 24.77 ± 0.80 mm at 12 weeks, and 25.32 ± 0.85 mm at 36 months. Although mild corneal epithelial disorders occurred in 18% of eyes, they were successfully treated with eye drops, enabling resumption of lens usage. No serious adverse events were observed. CONCLUSION: Orthokeratology lens (BREATH-O CORRECT R) use in children demonstrated good efficacy and safety during 3 years of follow-up.

Efficacy and safety of 0.01% atropine for prevention of childhood myopia in a 2-year randomized placebo-controlled study.

PURPOSE: Atropine eye drops prevent the progression of myopia, but their use has not been tested in the Japanese schoolchildren population. Here, we evaluate the efficacy and safety of 0.01% atropine eye drops for myopia control in Japanese children. STUDY DESIGN: Multicenter (7 university hospitals), randomized, double-masked, placebo-controlled trial. METHODS: Participants were 171 Japanese schoolchildren aged 6 to 12 years, with progressive myopia, spherical equivalence (SE) of -1.00 to -6.00 diopters (D), and astigmatism of ≤1.5 D. They were randomized to receive either 0.01% atropine (n=85) or placebo (n=86) eye drops once nightly OU for 24 months. Primary and secondary efficacy endpoints were changes in SE and axial length (AL), respectively, from baseline to month 24. RESULTS: Data from 168 subjects were analyzed. At month 24, compliance was similar in both groups (atropine: 83.3%; placebo: 85.7%). The least squares mean change in SE and AL from baseline were, respectively, -1.26 D (95% confidence interval [CI]: -1.35, -1.17) and 0.63 mm (0.59, 0.67) for atropine and -1.48 D (- 1.57, -1.39) and 0.77 mm (0.73, 0.81) for placebo. Inter-group differences were 0.22 D (95% CI: 0.09, 0.35; P < 0.001) for SE and - 0.14 mm (-0.20, -0.08; P < 0.001) for AL. Three patients experienced mild allergic conjunctivitis side effects, with no inter-group difference in incidence (atropine: 2.4%; 2/84 patients; placebo: 1.4%; 1/84 patients). CONCLUSION: With good compliance, 0.01% atropine is effective and safe for preventing the progression of childhood myopia.

Long-term course of contrast sensitivity in eyes after laser-assisted in-situ keratomileusis for myopia.

PURPOSE: To evaluate the long-term contrast sensitivity (CS) after laser in-situ keratomileusis (LASIK) for myopia. METHODS: This retrospective, single-center, cohort study involved 190 eyes of 95 patients who underwent bilateral LASIK between January 2001 and October 2007. This study includes patients who underwent CS and higher-order aberration (HOA) measurements in a five-year postoperative period. For all enrolled patients, visual acuity, refractive error (RE) in diopters (D), CS at 3-, 6-, 12-, and 18-cycles per degree (cpd), and HOA in a 4 mm area of the dilated pupil were measured before surgery and 6 months, 1 year, and 5 years after it. RESULTS: The mean RE measured before the surgery and after 6 months, 1 year, and 5 years after was -6.08 ± 2.50D, -0.26 ± 0.65D, -0.28 ± 0.65D, and -0.48 ± 0.80D, respectively. There were no clinically significant changes between preoperative results and the measures taken 6 months, 1 year, and 5 years after surgery. The slight increase in HOA had little effect on CS over the mid to long-term postoperative period. CONCLUSION: Our findings show that CS does not clinically change post LASIK. Although we were unable to identify the specific mechanism, we theorize that after LASIK there is a possibility for the compensation of HOA.