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      Motivación y satisfacción de los pacientes miopes sometidos a cirugía LASIK Translated title: Motivation and satisfaction of myopic patients undergoing LASIK surgery

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          Abstract

          OBJETIVO: Analizar la motivación y los niveles de satisfacción de los pacientes miopes sometidos a la cirugía refractiva con excímer láser. MÉTODOS: Se realizó una encuesta a 126 pacientes miopes (241 ojos), que asistieron a la consulta de cirugía refractiva en el Hospital Militar "Dr. Carlos Juan Finlay", los cuales fueron intervenidos con cirugía refractiva LASIK, con el propósito de analizar sus principales motivaciones y el grado de satisfacción obtenido después de transcurridos 3 meses de realizada la cirugía. Se estudiaron las siguientes variables: datos personales, motivación por la cirugía, refracción, agudeza visual, efectos secundarios y grado de satisfacción en general, así como su relación con las demás variables analizadas. RESULTADOS: La edad media de los encuestados fue de 30 años (de 20 a 54 años). Se encontró una mayor frecuencia de miopes en el sexo femenino (68,2 %). La graduación previa fue de un rango de -1,50 D a -12 D de equivalente esférico, y en el momento de la encuesta en más del 90 % de los pacientes era inferior a ± 1D. La motivación principal en el 82,9 % de los pacientes fue mejorar la agudeza visual, en el 9,9 %, la comodidad, en el 2,4 % la intolerancia a lentes de contacto, en el 1,2 % mejorar la imagen, y en el 1,6 % por acceso a puestos de trabajo, así como la diferencia de la visión entre un ojo y otro. El grado de satisfacción de los encuestados fue: 96,3 % muy contento, 2,8 % bastante contento, 0,4 % algo descontento y 0,4 % muy descontento. El grado de satisfacción estuvo relacionado con la graduación previa del paciente. Los pacientes más contentos fueron los que se operaron para mejorar la agudeza visual. De forma general el grado de satisfacción (más del 98 %) fue elevado. CONCLUSIONES: El grado de satisfacción de los pacientes intervenidos con LASIK fue aceptable o alto en la mayoría de los casos.

          Translated abstract

          OBJECTIVE: To analyze motivation and levels of satisfaction of myopic patients who under went Excimer laser refractive surgery. METHODS: One hundred and twenty six myopic patients (241 eyes), who had gone to the Refractive Surgery service and operated on by LASIK refractive surgery at Dr. "Carlos J. Finlay" Military Hospital, were surveyed to analyze their main motivation and the level of satisfaction three months after surgery. The following variables were included personal data, motivation for surgery, refraction, visual acuity, side effects and general level of satisfaction as well as their relation with the other analyzed variables. RESULTS: The average age of surveyed patients was 30 years (20 to 54 years). Myopic females were more common (68.2 %). The previous prescription ranged -1.50 to -12 D of spheral equivalent, and at the time of survey, it was under ± 1D. The main motivation found in 82.9 % of patients was improvement of their visual acuity; 9.9 % wanted more comfortability, 2.4 % expressed intolerance to contact lenses, 1.2 % desired to improve their image and 1.6% needed it to get access to new jobs, as well as vision differences between the eyes. The level of satisfaction was as follows: 96.3 % of the surveyed people were very pleased, 2.8 % pretty satisfied, 0.4 % was little satisfied and 0.4 % very unsatisfied. The level of satisfaction was related to the previous prescription of the eyes of the patient. The most satisfied patients were those who had undergone surgery to improve their visual acuity. Generally speaking, the level of satisfaction was high (over 98 %). CONCLUSIONS: The level of satisfaction of the operated patients with LASIK was acceptable or high in most of cases.

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          Most cited references21

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          Excimer laser surgery of the cornea.

          The excimer laser, which produces light in the far-ultraviolet portion of the spectrum, allows precise removal of corneal tissue through a photochemical laser-tissue interaction. This interaction is not thermal and does not involve optical breakdown; rather, it directly breaks organic molecular bonds without tissue heating. We used this process of ablative photodecomposition to remove corneal tissue in a series freshly enucleated cow eyes. Applying the far-ultraviolet light in short intense pulses permitted us to control the depth of the incision with great precision. We found that 1 joule/cm2 ablates corneal tissue to a depth of 1 micron. Adjacent tissue suffered no thermal damage and the stromal lamellae adjacent to the incision showed no evidence of disorganization.
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            Biomechanics of the cornea and wavefront-guided laser refractive surgery.

            Wavefront-guided laser refractive surgery induces postoperative optical aberrations that are not explained by the ablation profile. A conceptual model is presented for a potential mechanism of surgically-induced corneal shape change that is dependent on structural modification, rather than ablation profile. Examples are provided from clinical and basic studies that are consistent with the proposed model. Corneal biomechanical response to ablative surgery may significantly affect outcomes, and should be taken into account when planning customized procedures.
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              The correction of high myopia using the excimer laser.

              To determine the safety and efficacy of excimer laser photoablation as a treatment to correct high myopia that is defined as a spherical equivalent refractive error greater than -8.00 diopters (D). Using a multizone (4.0-, 5.0-, and 6.0-mm) photorefractive keratectomy protocol for correction of high myopia, 23 eyes in 18 patients were treated at one clinical center with an excimer laser (VISX Inc, Santa Clara, Calif). Preoperative spherical equivalent refractions ranged from -8.00 to -19.50 D (mean +/- SD, -11.83 +/- 2.92 D); the mean attempted ablation depth was 93.0 +/- 20.2 microns. At the last postoperative examination (mean +/- SD, 7.5 +/- 3.7 months), the mean +/- SD spherical equivalent refraction was -1.09 +/- 2.08 D, including results from two repeated procedures; visual acuity in 52% of the eyes was 20/40 or better uncorrected; 65% of the eyes improved or did not change best corrected acuity, whereas two eyes lost 2 Snellen lines; 39% of the eyes were +/- 1.00 D; and 65% were +/- 2.00 D of attempted correction. Corneal haze (corneal clarity score of > or = 1.5) was observed in 47% of the eyes at some time postoperatively. Photorefractive keratectomy for high myopia was found to be not nearly as efficient or predictable as it is for low myopia. A greater incidence of regression of refractive effect and corneal haze were noted in these cases compared with reported studies of low to moderate myopia. A multizone approach to reduce ablation depth during photorefractive keratectomy for myopia that is greater than 8.00 D does not appear to prevent subsequent haze or refractive regression.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                oft
                Revista Cubana de Oftalmología
                Rev Cubana Oftalmol
                Editorial Ciencias Médicas (Ciudad de la Habana )
                1561-3070
                June 2009
                : 22
                : 1
                : 0
                Affiliations
                [1 ] Instituto Cubano de Oftalmología Ramón Pando Ferrer. Cuba
                Article
                S0864-21762009000100007
                2ba237c5-64d8-448e-8090-a4d459dd1f3f

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0864-2176&lng=en
                Categories
                OPHTHALMOLOGY

                Ophthalmology & Optometry
                Excimer laser,myopia,patient's satisfaction,Láser excímer,miopía,satisfacción del paciente

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