To compare the early postoperative visual rehabilitation after laser-assisted subepithelial keratectomy (LASEK) and photorefractive keratectomy (PRK) for the correction of myopia.
CODET Aris Vision Institute, Tijuana, Mexico.
This prospective study included 50 eyes of 25 patients with myopia who received LASEK in 1 eye and PRK in the contralateral eye. Excimer laser corneal ablation was done using the Nidek EC-5000 excimer laser. Patients were seen at 1 and 3 days, 1 week, and 1 month. Discomfort, subjective uncorrected visual acuity (UCVA), objective UCVA, best corrected visual acuity (BCVA), corneal clarity (haze), and time for corneal reepithelialization were analyzed.
Seventy-two percent and 80% of the LASEK eyes had more discomfort at 1 day and 3 days, respectively. Eighty percent and 96% of the PRK eyes had better subjective UCVA at 1 day and 3 days, respectively. Corneas were fully reepithelialized at a mean of 3.3 days +/- 0.5 (SD) and 3.6 +/- 0.5 days in the PRK and LASEK groups, respectively. At 1 month, the UCVA was similar in both groups; no eye had lost lines of BCVA or developed haze.
Both LASEK and PRK were effective and safe procedures in the surgical correction of myopia at the 1-month postoperative visit. Patients reported less discomfort and better visual acuity in their PRK eye during the early postoperative period. Patients should be informed that LASEK, whose acronym is similar to that of laser in situ keratomileusis, has a recovery speed that is similar to that of surface laser refractive procedures such as PRK.
"Laser epithelial keratomileusis (LASEK) is a surgery that corrects refractive errors to a desired level by creating a corneal epithelial flap, irradiating the exposed Bowman's layer with excimer laser, and then re-placing the flap,1,2 with the use of therapeutic contact lenses after surgery. With regards to recovery after LASEK, the scar healing process and epithelium recovery may differ depending on whether the epithelial flap survives or not. "
[Show abstract][Hide abstract] ABSTRACT: To determine the effect of the base curve radius (BCR) of therapeutic soft contact lens (T-lens) on epithelial healing after laser-assisted subepithelial keratectomy (LASEK).
Ninety-two eyes in 47 patients with myopia were prospectively evaluated after LASEK. All the patients wore T-lenses with the BCR (R1) randomly chosen after LASEK. The T-lenses were removed after complete healing of the epithelial wounds. We calculated an estimated BCR (R2) from postoperative topography using a diopter conversion table. The patients were divided into two groups according to the differences between the BCR (R1) and the estimated BCR (R2). The flat fitting group was R1 > R2 (Group A), and the steep fitting group was R1<R2 (Group B). Patient's age, epithelial healing time, ablation amount, and BCR were compared between these two groups.
Group A (R1>R2) had 53 eyes, and Group B (R1<R2) had 39 eyes. Group A showed a shorter epithelial healing time than Group B (5.8+/-1.7 days vs. 6.7+/-2.1 days, p=0.04).
The flat fitting group showed a shorter epithelial healing time than the steep fitting group after LASEK.
Korean Journal of Ophthalmology 06/2007; 21(2):85-9. DOI:10.3341/kjo.2007.21.2.85
[Show abstract][Hide abstract] ABSTRACT: Refractive laser surgery has become one of the most successful and commonly performed elective ophthalmic procedures. Since the introduction of photorefractive keratectomy, followed closely by the advent of laser in situ keratomileusis, the field of laser refractive surgery has continued to rapidly evolve. Surgical techniques are constantly refined to improve patient outcomes and minimize complications, and technology continues to advance to provide more precise and customizable treatment options. New applications of refractive procedures continually emerge in the literature. Breakthroughs in the field have led to novel applications of refractive procedures that may offer options to patients that previously had been considered poor surgical candidates. It is important for the clinician to maintain awareness of the current trends and new developments in refractive surgery to provide appropriate counseling and treatment for their patients.
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