Short-term corneal endothelial changes after laser-assisted subepithelial keratectomy

Long term results of no-alcohol laser epithelial keratomileusis and photorefractive keratectomy for myopia

AIM

To evaluate the long term clinical results of mechanical no-alcohol-assisted laser epithelial keratomileusis (LASEK) versus standard photorefractive keratectomy (PRK) for low-moderate myopia.

METHODS

Twenty-five eyes treated with LASEK and twenty-five eyes treated with PRK were evaluated with a mean follow-up duration of 60mo. Mechanical separation of the epithelium was performed with blunt spatula and without application of alcohol. Laser ablation was performed with the MEL-70 excimer laser. All patients were examined daily until epithelial closure; at 1, 3, 6, and 12mo, and every year subsequently. Main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, haze, efficacy and safety indexes.

RESULTS

Twenty-one eyes and 22 eyes completed follow-up of 60mo in LASEK and PRK group respectively. Manifest refraction at 60mo follow-up was -0.01 and 0.26 in LASEK and PRK group respectively. In the LASEK group mean UDVA and mean CDVA after 60mo were 20/22 and 20/20 respectively (P>0.01). In the PRK group mean UDVA and mean CDVA at 60mo follow-up were 20/20 and 20/20 after 60mo (P>0.01). The efficacy indexes were 0.87 and 0.95, and the safety indexes were 1.25 and 1.4 respectively for LASEK group and PRK group.

CONCLUSION

Both standard PRK and no-alcohol LASEK offer safe and effective correction of low-moderate myopia in the long term without any statistically significant difference between the two groups.