AIM: To evaluate the long-term outcomes of free-flap laser subepithelial keratomileusis(LASEK)for treatment of high myopia.

METHODS: Two hundred and nine patients(277 eyes)with high myopia were treated with free-flap LASEK in our hospital, each patient was followed up for 5a. Patients were divided into two groups including groupⅠwith high myopia(<-9.00D, 145 eyes of 115 cases)and groupⅡ(≥-9.00D, 132 eyes of 94 cases). All patients were evaluated at 1, 5d, 1wk, 1, 3, 6mo, 1, 2 and 5a after surgery. The postoperative irritation, uncorrected and corrected visual acuity, refractive status, corneal complications, intraocular pressure were observed and analyzed.

RESULTS: On the fifth day after surgery, all epithelial flaps were nearly transparent and 96.3% patients had postoperative irritation symptom such as wear eye pain, photophobia, tearing, foreign body sensation but all could tolerate. Five years after operation, 131 eyes(90.3%)had uncorrected visual acuity(UCVA)of ≥1.0, 145 eyes(100%)≥0. 8 in group Ⅰ; 104 eyes(78. 8%)had UCVA of ≥1.0, 119 eyes(90.2%)≥0. 8, 129 eyes(97.7%)≥0. 6 and 3 eyes(2. 3%)<0.6 in group Ⅱ. The diopter tended to be stable in both groups after 6mo and there was no statistically significant difference after 6mo and 5a(P>0. 05), but there was statistical significance difference between each time point of postoperative and preoperative(P<0.01). The two groups had refraction regression, but had no serious intraoperative and postoperative complications, the main complications included haze, refractive regression and high intraocular pressure.

CONCLUSION: Free-flap LASEK is one of methods to treat eyes with high myopia safely and effectively, but should be cautious for super-high myopia.