Prospective, Randomized Comparison of Axial Elongation after LASIK versus Soft Contact Lens Wear in the Contralateral Eye

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Purpose: To evaluate whether LASIK induces axial elongation comparable to or less than that observed with continued soft contact lens (SCL) wear in myopic eyes. Design: A prospective, randomized-controlled within-person clinical trial. Participants: Forty-two eyes from 21 patients (11 males, 10 females; mean age: 26 ± 4 years) with myopia or compound myopic astigmatism. Methods: In this contralateral-eye, randomized clinical trial, each participant underwent wavefront-guided (WFG) LASIK in 1 randomly assigned eye, while the fellow eye continued SCL wear. Axial length (AL), spherical equivalent (SE), higher-order aberrations (HOAs), visual acuity, and contrast sensitivity were assessed preoperatively and every 6 months for 2.5 years. The primary outcome was axial elongation from 6 months to 2.5 years postoperatively. Data were analyzed using linear mixed-effects models. Main Outcome Measures: Axial elongation. Results: The mean preoperative SE in LASIK-treated eyes was -6.23 ± 1.95 diopters. In the early postoperative phase, a significant reduction in AL exceeding corneal thinning was observed, suggesting true axial shortening. From 6 months to 2.5 years, axial elongation did not significantly differ between the LASIK and SCL eyes. Although HOAs at a 6-mm pupil diameter increased more in LASIK-treated eyes, most participants reported subjectively superior visual quality in those eyes. Conclusions: LASIK was associated with early axial shortening and did not accelerate long-term axial elongation compared with SCL wear. These results suggest a potential modulatory effect of WFG-LASIK on AL progression and support the need for further longitudinal studies. Financial Disclosures: The authors have no proprietary or commercial interest in any materials discussed in this article.

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