Purpose: To assess the long-term refractive outcome of laser in situ keratomileusis (LASIK) for myopia and myopic astigmatism

Design:  An observational, single center, multisurgeon case series

Methods: This study was a follow up study of 128 patients contacted to return for repeat investigation post refractive surgery. It included 245 eyes of 128 patients who underwent LASIK for myopia or myopic astigmatism at the Ho Chi Minh City Eye Hospital, Vietnam in 2008. Surgical parameters as well as patient data at presentation, three months and five years after surgery were analyzed. The main outcome was spherical equivalent (SE) within ± 0.5D at 5 years. 

Results: At the fifth year follow up, 80% of eyes were within ± 0.5D and 98% of eyes were within ± 1.0D of emmetropia. No eyes underwent laser enhancement prior to the last visit although the retreatment criteria was met in 45 eyes (18.4%). The mean SE decreased from 0.16 ± 0.33 at 3 months to -0.07 ± 0.50 at 5 years for the whole cohort. Patients with severe myopia were most susceptible to myopic regression and had a less predictable refractive outcome. The overall UCVA of 20/20 or better and of 20/40 or better were obtained in 68.2% and 95.1% of eyes. Fourteen eyes (5.7%) improved 1 line of BCVA. Forty two eyes (17.1%) lost 2 lines of BCVA which were unrelated to laser complications.

Conclusion: Although there was myopic regression over time, LASIK provided excellent  5 year refractive outcome for myopia and myopic astigmatism.  Almost 20% of patients meet criteria for retreatment but do not seek a retreatment in this Vietnamese population.