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: dovepress.com[show abstract] [hide abstract]
ABSTRACT: Correction of refractive errors can be achieved with spectacles, contact lenses, and refractive surgery. The past decade has seen a surge in the availability of alternatives for patients and surgeons in terms of both surgical and nonsurgical options for the management of refractive errors. Newer generation contact lenses provide enhanced safety and better handling, whereas modern-day refractive surgery presents a plethora of choices based on the clinical characteristics and requirements of patients. We have moved from an era of "one size fits all" to a purely customized way of treating patients with refractive errors. This review presents the background, advantages, and disadvantages of the two most commonly used options for correction of ametropia, ie, contact lenses and refractive surgery.Clinical Optometry. 01/2011; 3:63-72.
- [show abstract] [hide abstract]
ABSTRACT: Purpose: To evaluate morphologic changes in human corneal epithelial flap removed mechanically or after ethanol application. Method: Epithelial corneal flap was removed after ethanol application (20 eyes) or mechanically (19 eyes). Any changes were studied by transmission electron microscopy. Results: Thirty-nine eyes were enrolled in the study. The following changes were found in the alcohol-applied group: apoptotic cells, membrane-bound blebs with marked dilatation of endoplasmic reticulum, and short intercellular cleavage with approximately one-third of cell length depth. In mechanical debridement, cleavages extended more than half of the cell length by tearing hemidesmosomes. Conclusion: Alcohol application leads to cell damage in basal epithelial cells but cleavage plane remains smooth. Generally, none of the methods caused trauma to the basement membrane.Ultrastructural Pathology 12/2012; 36(6):400-403. · 0.98 Impact Factor
- [show abstract] [hide abstract]
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