Laser-assisted subepithelial keratectomy versus photorefractive keratectomy for the correction of myopia. A prospective comparative study.
ABSTRACT 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.
- SourceAvailable from: Saeed PayvarJournal of refractive surgery (Thorofare, N.J.: 1995) 20(1):90-1. · 2.47 Impact Factor
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ABSTRACT: To examine possible differences in clinical outcomes between laser-assisted subepithelial keratectomy (LASEK) and photorefractive keratectomy (PRK) for myopia. Systematic review and meta-analysis. Patients from previously reported randomized controlled trials (RCTs) and comparative studies of LASEK and PRK with clinical outcomes. A comprehensive literature search was performed using the Cochrane Collaboration methodology to identify RCTs and comparative studies comparing LASEK and PRK for myopia. Primary outcome parameters included uncorrected visual acuity (UCVA) of 20/20 or better, manifest refractive spherical equivalent (SE) within ± 0.50 diopters (D), final refractive SE, and final UCVA of 20/40 or worse. Secondary outcome parameters included healing time of corneal epithelium, postoperative pain, and corneal haze. Twelve studies were identified and used for comparing PRK (499 eyes) with LASEK (512 eyes) for myopia. There were no significant differences in odds ratio (OR), weighted mean difference (WMD), and standardized mean difference (SMD) in the primary and secondary outcome measures. The final mean refractive SE (WMD, 0.00; 95% confidence interval [CI], -0.08 to 0.07; P = 0.95), manifest refractive SE within ± 0.50 D of the target (OR, 0.90; 95% CI, 0.63-1.29; P = 0.56), patients achieving UCVA of 20/20 or better (OR, 0.86; 95% CI, 0.61-1.20; P = 0.37), final UCVA of 20/40 or worse (OR, 1.26; 95% CI, 0.63-2.51; P = 0.52), re-epithelialization time (WMD, 0.08; 95% CI, -0.44 to 0.59; P = 0.77), and postoperative pain (SMD, 0.26; 95% CI, -0.20 to 0.72; P = 0.27) were analyzed. However, LASEK-treated eyes showed less corneal haze at 1 month after surgery (WMD, 0.25; 95% CI, 0.10-0.39; P = 0.0007) and 3 months after surgery (WMD, 0.14; 95% CI, 0.01-0.26; P = 0.03) compared with PRK. No statistically significant difference was observed between the 2 groups at 6 months after surgery (WMD, 0.14; 95% CI, -0.02 to 0.30; P = 0.08). In this meta-analysis, LASEK-treated eyes had no significant benefits over PRK-treated ones with regard to clinical outcomes. Less corneal haze was observed in LASEK-treated eyes at 1 to 3 months after surgery.Ophthalmology 10/2010; 117(10):1912-22. · 5.56 Impact Factor
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ABSTRACT: To identify possible differences in clinical outcomes between laser-assisted subepithelial keratectomy (LASEK) and epipolis laser in situ keratomileusis (Epi-LASIK) for myopia following a meta-analysis. Meta-analysis. Patients from previously reported comparative studies treated by LASEK versus Epi-LASIK. A systematic literature retrieval was conducted in the MEDLINE, EMBASE, and Cochrane Library, up to January 2013. The included studies were subject to a meta- analysis using a revman 5.1 version software. The possible differences in efficacy, predictability, safety, epithelial healing time, pain perception and corneal haze formation. A total of 6 studies involving 517 eyes were included. There were no statistically significant differences in the final proportion of eyes with uncorrected visual acuity (UCVA) of 20/20 or better (p = 0.43), mean postoperative UCVA (p = 0.53), final proportion of eyes with refraction within ±0.50D (p = 0.62) and ±1.00D (p = 0.16) of target, final proportion of eyes losing 2 or more lines of best spectacle-corrected visual acuity (BSCVA) (p = 1.00), healing time of corneal epithelium (p = 0.58), final proportion of eyes with corneal haze grade 0.5 or higher (p = 0.26), and corneal haze levels (p =0.36). Our meta-analysis found no significant differences in efficacy, predictability, safety, epithelial healing time, and corneal haze formation between LASEK and Epi-LASIK, but the result was limited. Future high methodological quality studies with a larger number of subjects, identical intervention parameters, complete outcome measurements, and longer follow-up duration are needed to detect the potential differences between the two procedures.Clinical and Experimental Ophthalmology 09/2013; · 1.96 Impact Factor