An interval-censored model for predicting myopic regression after laser in situ keratomileusis

Invest Ophthalmol Vis Sci. 2007 Aug;48(8):3516-23. doi: 10.1167/iovs.06-1044.

Abstract

Purpose: A time-varying statistical model was proposed to predict the risk of regression toward myopia after laser in situ keratomileusis (LASIK) and to identify significant predictors within a time frame.

Methods: A total of 615 eyes of 311 patients derived from a retrospective cohort who underwent LASIK in 2003 were analyzed. Refraction outcomes were recorded at 1 day, 1 week, and 1, 3, 6, 9, and 12 months or longer after LASIK. A cross-validated design was used, to split data into trained (n = 308) and validated (n = 307) data sets. These data sets were used in an interval-censored model to predict the probability of regression toward myopia and to assess the predictors including demographic features and preoperative and postoperative variables.

Results: Myopia regression was observed in 164 (26.7%) of 615 eyes during the follow-up period of 12 months or longer after LASIK. Significant predictors for myopia regression after LASIK included preoperative manifest spherical equivalent (P = <0.0001), mean preoperative central corneal curvature (P = 0.001), size of optic zone (P = 0.0043), undercorrection (P = 0.04), and age (P = 0.0734). The risk of regression toward myopia after LASIK increased rapidly within 1 month, slowed down between 1 and 6 months, and became steady after 6 months, regardless of risk group. The risk of myopia regression up to 6 months after LASIK was 21% in average-risk eyes (based on all eyes).

Conclusions: The proposed interval-censored model was useful not only for predicting the probability of myopia regression after LASIK but also for identifying the evolution of patients within low, moderate, and high-risk groups.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Keratomileusis, Laser In Situ / statistics & numerical data*
  • Male
  • Models, Statistical*
  • Myopia / epidemiology*
  • Myopia / physiopathology
  • Myopia / surgery*
  • Postoperative Complications / epidemiology*
  • Predictive Value of Tests
  • Prevalence
  • Probability
  • ROC Curve
  • Refractive Errors
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Factors