The Open Ophthalmology Journal

ISSN: 1874-3641 ― Volume 12, 2018

Simultaneous Accelerated Corneal Crosslinking and Laser In situ Keratomileusis for the Treatment of High Myopia in Asian Eyes

Jin Rong Low, Li Lim*, Jane Chwee Wah Koh, Daniel Kai Peng Chua, Mohamad Rosman
Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore



LASIK Xtra is a recently described technique which combines LASIK and accelerated corneal cross-linking(CXL) in the same setting. Its long-term outcome in Asians with high myopia is not well described.


To compare the efficacy, predictability and safety of LASIK Xtra with LASIK in patients with high myopia.


This is a retrospective study comparing 50 consecutive eyes undergoing LASIK Xtra for the correction of high myopia and/or myopic astigmatism (-6.63 to -15.50 D manifest spherical equivalent) with a matched control group of 50 eyes undergoing LASIK alone for correction of high myopia (-6.00 to -12.25 D manifest spherical equivalent). Mean follow-up was 5.7 months (range, 1.5-13.3 months) for LASIK Xtra and 3.6 months (range, 1.7-4.2 months) for LASIK only. Outcome measures included Uncorrected Distance Visual Acuity (UDVA), Corrected Distance Visual Acuity (CDVA), refraction and intraoperative and postoperative complications.


At post-operative 3 months, all eyes achieved UDVA of 20/40 or better, and 80.0% of LASIK Xtra eyes achieved UDVA of 20/20 or better, compared to 66.0% of LASIK only eyes (p = 0.115). Efficacy indices were 0.99±0.17 for LASIK Xtra and 0.94±0.17 for LASIK only (p = 0.164). The proportion of eyes within ±0.50 D of attempted correction was 84% in the LASIK only group and 72% in the LASIK Xtra group at post-operative 3 months (p = 0.148). Safety indices were 1.11±0.19 and 1.11±0.18 in the LASIK Xtra and LASIK only groups, respectively (p = 0.735).


LASIK Xtra achieved comparable safety, predictability and efficacy as LASIK in patients with high myopia. Good refractive stability was attained at 6-12 months. Further long term studies are required to determine whether simultaneous CXL is able to reduce postoperative LASIK keratectasia in high-risk individuals.

Keywords: Corneal crosslinking, Laser in situ keratomileusis, High myopia, Refractive surgery, Keratorefractive surgery, LASIK Xtra.

Article Information

Identifiers and Pagination:

Year: 2018
Volume: 12
Issue: Suppl-1, M3
First Page: 143
Last Page: 153
Publisher Id: TOOPHTJ-12-143
DOI: 10.2174/1874364101812010143

Article History:

Received Date: 06/06/2017
Revision Received Date: 25/11/2017
Acceptance Date: 28/01/2018
Electronic publication date: 23/07/2018
Collection year: 2018

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© 2018 Low et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751, Singapore; Tel: +6562277255; E-mail:


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