Abstract

Objective To compare laser in situ keratomileusis (LASIK) with photorefractive keratectomy (PRK) in the correction of myopia from −2.00 to −5.50 diopters. Design Prospective, randomized, paired clinical trial. Participants Fifty-two eyes of 26 myopic patients were enrolled in the study. Intervention Each patient received PRK on one eye (PRK eye) and LASIK on the other (LASIK eye); the procedure assigned to each eye, and the sequence of surgeries for each patient was randomized. Main outcome measures Slit-lamp microscopy, manifest refraction, uncorrected and spectacle-corrected visual acuity, and videokeratography were done before operation, and 2 weeks, 6 weeks, 3 months, 6 months, and 12 months after operation. Patient satisfaction and preference were assessed by a subjective questionnaire. Results All LASIK eyes had fast, painless recovery. At 1 year, 24 patients (92.3%) were examined, the mean spherical equivalent refraction was −0.08 ± 0.38 diopter in the PRK eyes and −0.14 ± 0.31 diopter in the LASIK eyes, and the uncorrected visual acuity was 20/20 or better in 15 PRK eyes (62.5%) and 19 LASIK eyes (79.2%); no eye lost 2 or more Snellen lines of spectacle-corrected visual acuity. Both procedures were stable throughout the first year. One PRK eye developed dense subepithelial corneal haze. The strongest correlate to spectacle-corrected visual acuity after the two procedures was the coefficient of variation of corneal power over the pupil. Nineteen patients (79.2%) preferred the LASIK procedure because of the fast, painless recovery. Conclusions In the current study, PRK and LASIK were found to be similarly effective, predictable, stable, and reasonably safe for the correction of myopia between −2.00 and −5.50 diopters. Laser in situ keratomileusis has the advantage of fast, painless recovery. Patients prefer LASIK.

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