Clinical comparison of Epi-LASIK and off-flap Epi-LASIK for the treatment of moderate to high myopia

Abstract

Objective To compare the postoperative course and the clinical results of off-flap Epi-LASIK and Epi-LASIK for the treatment of moderate to high myopia for 1 year. Methods Corneal epithelial flaps of 28 patients with moderate to high myopia were separated with an Amadeus II epikeratome.A patient's eye was randomly treated with flap-off Epi-LASIK.The other eye was underwent Epi-LASIK.All patients' corneal stroma was ablated by TECHNOLAS 217Z100 excimer laser.Pain scores,pain time and uncorrected visual acuity (UCVA) were evaluated at the 4 to 7 days after surgery.UCVA,spherical equivalent,best corrected visual acuity (BCVA) and haze scores were recorded at 2 weeks,1 month,3 months,6 months and 1 year after surgery. Results The mean preoperative spherical equivalent of Epi-LASIK and flap-off Epi-LASIK were-7.39±2.21D and -7.69±2.38D,P =0.12.Compared with the Epi-LASIK eyes,the better UCVA at 4 or 5 and 14 days after surgery (P =0.01,0.046) and the lower pain scores (P =0.049) were found in off-flap Epi-LASIK eyes.Painful time had no significant difference between 2 groups.There was no significant difference between the 2 groups at the other postoperative intervals in terms of spherical equivalent and UCVA.There was no significant between-group difference in the change in lines of BCVA at 1 year after surgery.The lower level of haze scores at 2 weeks and 3 months after surgery (P=0.00,0.01) were found in off-flap Epi-LASIK eyes. Conclusions Off-flap Epi-LASIK offers the less postoperative pain,the lower level of haze formation and a faster visual recovery speed than Epi-LASIK for the treatment of moderate to high myopia. Key words: Myopia; Epi-LASIK; Haze