Vermessung der skotopischen Pupille

[A prospective intraindividual comparison between laser in situ keratomileusis and laser subepithelial keratectomy for myopia. 1-year follow-up results]

BACKGROUND

The aim of this study was to intraindividually compare the outcome of laser in situ keratomileusis (LASIK) and laser subepithelial keratectomy (LASEK) in patients with similar refraction in both eyes when treated with two different procedures.

PATIENTS AND METHODS

In this prospective nonrandomized study, 30 myopic patients with and without astigmatism were treated by Lasik in one eye and LasEk in the fellow eye. All eyes were treated using the MEL 70-G Excimer laser (Carl Zeiss Meditec, Germany). Uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) as well as photopic contrast sensitivity (Pelli-Robson charts) and scotopic contrast sensitivity (Nyktometer, Rodenstock, Germany) were evaluated. The patients were also asked about their preferences regarding the procedures.

RESULTS

The preoperative spherical equivalent (SE) was -4.54+/-1.64 D and the mean BSCVA was 0.94 in Lasik eyes. The SE was -3.9+/-1.57 D and the BSCVA was 0.89 in LASEK eyes. The mean 1-year post-operative SE was -0.33+/-0.48 D in the Lasik eyes and -0.19+/-0.26 D in the LASEK eyes. Efficacy and safety were similar in the two groups, but Lasik eyes had a greater standard deviation at 1 year. Pelli-Robson contrast sensitivity was 10.75+/-3.05 in the Lasik eyes compared with 11.4+/-3.21 in the fellow LASEK eyes. Seventeen patients named Lasik and 12 patients named LASEK as their procedure of choice.

CONCLUSION

Both procedures enable similarly good results. LASEK showed a tendency to a smaller standard deviation in final refraction and better contrast sensitivity.

Klassifikation biomedizinischer Forschungsberichte als Grundlage evidenzbasierter Medizin in der Augenheilkunde

BACKGROUND

Evidence-based medicine requires careful appraisal of published data derived from experimental and clinical studies. Based on classification of biomedical research reports, evidence levels can be determined and recommendations for therapeutic decisions can be made.

METHODS

A classification system for clinical studies was developed. It was evaluated in classifying the reports published in Der Ophthalmologe during 2003-2004 (study design: descriptive cross-sectional study, case series).

RESULTS

In the 2-year interval, 70 longitudinal and 95 cross-sectional studies were published. The vast majority of the longitudinal studies were interventional cohort studies. Not considering case reports, 73% of the original articles were longitudinal prospective studies, 1% were retrospective (case-control) studies, and 26% were cross-sectional studies.

CONCLUSIONS

The study design of all published articles could be classified using the classification system. This classification system proves to be applicable in the context of clinical studies in ophthalmology and may be helpful in the process of critical appraisal of the literature and synthesis of clinical evidence and an evidence-based recommendation.