Laser in Situ Keratomileusis Outcomes and Complications: 2016 to 2023.

Abstract

Purpose: To review current clinical outcomes, complications, and patient satisfaction of laser in situ keratomileusis (LASIK) from studies published between 2016 and 2023, with a specific focus on refractive outcomes and topography-guided LASIK (TG-LASIK).

Methods: A literature review was conducted using PubMed and Scopus, identifying studies reporting LASIK outcomes, complications, and patient satisfaction. Inclusion criteria required studies to report aggregate clinical data, using validated metrics for subjective outcomes. Studies on re-treatment, specific corneal/systemic disorders, or follow-up shorter than 1 month were excluded. Separate analyses were performed for TG-LASIK and other LASIK treatments.

Results: Ninety-five studies met the final inclusion criteria. Myopic treatment achieved better outcomes than hyperopic treatment, with 88.3% and 69.2% reaching an uncorrected distance visual acuity (UDVA) of 20/20, respectively. TG-LASIK demonstrated superior refractive outcomes to LASIK myopic treatment, with 91.8% having 20/20 or better UDVA, and 95% and 100% of eyes achieving refractive accuracy within ±0.50 and ±1.00 diopters, respectively. Complication rates were low, with the most common being flap folds (0.73%). Sight-threatening complications occurred in 0.07% of the eyes. Patient satisfaction remained high, with 92.6% reporting satisfaction with surgery, and 99% would recommend the procedure to a friend.

Conclusions: LASIK remains a safe, effective, and highly satisfying refractive surgery, with TG-LASIK demonstrating superior outcomes compared to other LASIK treatments. Complications were infrequent, and subjective visual symptoms generally improved postoperatively. Future research should use standardized methods for assessing and reporting subjective outcomes, including preoperative and postoperative comparisons, to provide a more comprehensive understanding of LASIK outcomes. [J Refract Surg. 2025;41(4):e391-e403.].