Laser-assisted subepithelial keratectomy for myopia: two-year follow-up

Abstract

The authors conducted a prospective comparative study to assess and compare the clinical results (efficacy, safety, stability, and postoperative pain or discomfort) of laser-assisted subepithelial keratectomy (LASEK) and conventional photorefractive keratectomy (PRK) for the correction of low to moderate myopia. Laser-assisted subepithelial keratectomy was performed in one eye and PRK was performed in one eye in 92 patients who underwent bilateral treatment. Both procedures were performed with the Nidek EC-5000 excimer laser using the same parameters and nomogram, with the first eye being randomized. The preoperative mean spherical equivalent was −4.65 diopters (D) ± 3.14 D standard deviation (range, −1.75 D to −7.50 D). The mean pain level was significantly lower on days 1 to 3 in the LASEK eyes (P < .05). The mean uncorrected visual acuity was significantly better in LASEK (0.87) than PRK eyes (0.64) at 1 week (P < .05) but virtually identical at 1 month (0.89 vs 0.78), 1 year (0.91 vs 0.88), and 2 years (0.94 vs 0.92). The mean corneal haze was significantly lower in LASEK eyes (0.21) than in PRK eyes (0.43) (P < .05). The mean spherical equivalent at 2 years was −0.23 ± 0.46 D for LASEK eyes, and −0.18 ± 0.53 D for PRK eyes (not significant). There were no statistically significant differences between LASEK and PRK eyes in safety and efficacy indices. Overall, 86% of patients preferred LASEK over PRK. The authors conclude that LASEK provides significantly quicker visual recovery, less postoperative pain, and results in less subepithelial haze than PRK, although the long- term visual and refractive outcomes are virtually identical with the two procedures.—Michael D. Wagoner