Initial results of photorefractive keratectomy and laser in situ keratomileusis performed by a single surgeon

Abstract

Purpose To determine the safety and efficacy of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) early in a surgeon’s experience. Setting Ophthalmology Department, John A. Moran Eye Center, Salt Lake City, Utah, USA. Methods Between October 1995 and April 1997, a retrospective analysis was performed of 200 eyes in 128 patients who had PRK or LASIK with a follow-up of at least 3 months. The mean age was 38.1 years ± 10.4 (SD) in the PRK group and 42.3 ± 10.1 years in the LASIK group. There were 36 women and 30 men in the former and 32 women and 30 men in the latter. Photorefractive keratectomy, PRK/astigmatic keratotomy (AK), LASIK, or LASIK/AK was performed with the Summit Omnimed excimer laser. Preoperative evaluation included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), cycloplegic refraction, tonometry, and computerized videokeratography. At 1, 3, and 6 months, UCVA, BSCVA, mean spherical equivalent (SE), astigmatism, corneal haze, subjective vision (day, night, glare, and halo), and complications were measured. Results Mean SE was 0.16 ± 0.82 diopter (D) in the PRK group and −0.09 ± 0.63 D in the LASIK group at 1 month ( P < .05), −0.18 ± 0.66 D and −0.16 ± 0.58 D, respectively, at 3 months, and −0.33 ± 0.73 D and −0.09 ± 0.62 D, respectively, at 6 months. Achieved correction was similar in the 2 groups. Mean BSCVA was 22.8 ± 6.0 in the PRK group and 22.2 ± 5.3 in the LASIK group at 1 month, 21.1 ± 6.0 and 21.1 ± 3.1, respectively, at 3 months, and 19.8 ± 3.5 and 22.9 ± 5.2, respectively, at 6 months ( P < .005). Mean surface regularity index was 0.68 ± 0.40 in the PRK group and 0.86 ± 0.41 in the LASIK group at 1 month, 0.54 ± 0.26 and 0.72 ± 0.37, respectively, at 3 months ( P < .05), and 0.49 ± 0.27 and 0.84 ± 0.42, respectively, at 6 months. Mean surface asymmetry index was 0.71 ± 0.43 in the PRK group and 0.55 ± 0.21 in the LASIK group at 1 month ( P < .05), 0.53 ± 0.24 and 0.51 ± 0.23, respectively, at 3 months, and 0.46 ± 0.19 and 0.64 ± 0.54, respectively, at 6 months. The subjective parameters between the groups were significantly different only at 6 months; patients in the PRK group reported better day and night vision. Conclusion With careful preparation and proper training, PRK and LASIK appear to be safe and efficacious even during the surgeon’s early learning phases.