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Choi, Park, Kim, and Chung: Comparison of Laser Epithelial Keratomileusis Versus Epipolis-Laser in Situ Keratomileusis for Moderate to High Myopia
Original Article

J Korean Ophthalmol Soc 2007;48(9):1196-1201.

Published online: 30 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.9.1196

Comparison of Laser Epithelial Keratomileusis Versus Epipolis-Laser in Situ Keratomileusis for Moderate to High Myopia

Suk Kyue Choi, M.D., Hae Young Park, M.D., Yoon Hee Kim, M.D., Sung Kun Chung, M.D.

Department of Ophthalmology, Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Sung Kun Chung, M.D., Department of Ophthalmology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #62 Yoido-dong, Youngdeungpo-gu, Seoul 150-713, Korea, Tel: 82-2-3779-1243, Fax: 82-2-3779-6869, E-mail: eyedoc@catholic.ac.kr

Received 8 June 2006       Accepted 29 May 2007

Copyright © 2007 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the clinical visual results and complications of laser-assisted subepithelial keratectomy (LASEK) and epipolis laser in situ keratomileusis (Epi-LASIK).

Methods

A retrospective analysis of a case series of eyes treated with LASEK or Epi-LASIK with a follow-up of six months was performed. Twenty-two eyes were treated with LASEK, and 20 eyes were treated using Epi-LASIK. The main outcome measures were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and manifest refraction at one week, one month, three months, and six months after refractive surgery, and the presence of any complications.

Results

There was no significant difference of UCVA and mean postoperative spherical equivalent (SE) between the eyes treated with LASEK or Epi-LASIK at one week, three months, and six months. However at one month there was significant difference of UCVA. Additionally, in a comparison between moderate and serve myopia, there was no significant difference of UCVA and mean postoperative spherical equivalent (SE) between groups treated with LASEK or Epi-LASIK at one week, one month, three months, and six months. Seven eyes treated with LASEK and two eyes treated with Epi-LASIK showed persistent epithelial erosion less than one week. Two eyes treated with LASEK exhibited newly-developed corneal opacity, which persisted-through the last visit.

Conclusions

Epi-LASIK showed clinical visual results and complications comparable to LASEK and showed better epithelial healing.

Keywords: Epi-LASIK, LASEK, Postoperative spherical equivalent

References

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Table 1.
Demographies of LASEK and Epi-LASIK
LASEK∗ Epi-LASIK†
Age (years) 27.0±4.26 27.2±6.20
Sex M:F=1:11 M:F=1:10
Moderate myopia 15 eyes 15 eyes
High myopia 7 eyes 5 eyes
Total 22 eyes 20 eyes
Manifest refractive error (SE‡) (D) −5.48±1.18 −4.96±1.17
Cycloplegic refractive error (SE) (D) −5.02±1.18 −4.70±1.16

LASEK∗:Laser epithelial keratomileusis.

Epi-LASIK†:Epipolis laser in situ keratomileusis.

SE‡:Spherical equivalent.

Table 2.
Comparison of uncorrected visual acuity after LASEK and Epi-LASIK
Postoperative period
1 week
 1 month
 3 months
 6 months
LASEK Epi-LASIK LASEK Epi-LASIK LASEK Epi-LASIK LASEK Epi-LASIK
Moderate myopia 0.20±0.24 0.26±0.16 0.02±0.04 0.07±0.08 0.02±0.04 0.05±0.06 0.00±0.00 0.04±0.11
P‡ =0.285 P=0.250 P=0.202 P=0.539
High myopia 0.31±0.16 0.52±0.18 0.17±0.17 0.42±0.71 0.06±0.09 0.10±0.07 0.08±0.14 0.02±0.05
P=0.05 P=0.981 P=0.343 P=0.755
Total 0.23±0.22 0.33±0.20 0.06±0.11 0.15±0.37 0.02±0.06 0.06±0.07 0.02±0.08 0.03±0.10
P=0.125 P=0.385 P=0.057 P=0.591

P‡: Mann-Whitney test.

Table 3.
Comparison of post-operative residual spherical equvalent after LASEK and Epi-LASIK
Postoperative period
1 week
 1 month
 3 months
 6 months
LASEK Epi-LASIK LASEK Epi-LASIK LASEK Epi-LASIK LASEK Epi-LASIK
Moderate myopia 0.38±1.23 −0.3±0.67 −0.73±0.17 −0.12±0.68 −1.00±1.13 −0.34±0.48 −0.57±0.51 −0.470.40
P‡ =0.412 P=0.267 P=0.595 P=0.567
High myopia −0.5±0.80 −0.40±0.65 −0.33±0.48 −0.20±0.78 −0.41±0.46 −0.12±0.68 −0.38±0.40 −0.47±0.54
P=0.268 P=0.755 P=0.268 P=0.876
Total −0.20±0.99 −0.30±0.65 −0.45±0.66 −0.13±0.68 −0.57±0.74 −0.28±0.52 −0.43±0.43 −0.47±0.42
P=0.980 P=0.235 P=0.282 P=0.611

P‡: Mann-Whitney test.

Table 4.
Comparison of uncorrected visual acuity and manifest spherical equivalent between moderate myopia and high myopia in each groups after LASEK
Postoperative period
1 week
 1 month
 3 months
 6 months
visual acuity (logMAR‡) SE† visual acuity (logMAR) SE visual acuity (logMAR) SE visual acuity (logMAR) SE
Moderate myopia 0.20±0.20 0.38±1.23 0.02±0.04 0.73±0.17 0.02±0.04 −1.00± 1.13 0.00±0.00 −0.57±0.31
High myopia 0.31±0.20 0.50±0.80 0.17±0.17 0.33±0.48 0.05±0.09 −0.41±0.46 0.08±0.14 −0.38±0.40
P§=0.142 P=0.123 P=0.026 P=0.680 P=0.630 P=0.680 P=0.298 P=0.731

SE†: Spherical equvalent,

MAR‡: Minimal angle of resolution,

P§: Mann-Whitney test.

Table 5.
Comparison of uncorrected visual acuity and manifest spherical equivalent between moderate myopia and high myopia in each groups after Epi-LASIK
Postoperative period
1 week
 1 month
 3 months
 6 months
visual acuity (logMAR†) SE‡ visual acuity (logMAR) SE visual acuity (logMAR) SE visual acuity (logMAR) SE
Moderate myopia 0.26±0.20 0.30±0.67 0.07±0.08 −0.12±0.68 0.05±0.06 0.34±0.48 0.04±0.11 −0.47±0.40
High myopia 0.52±0.20 −0.40±0.65 0.42±0.71 −0.20±0.78 0.10±0.07 −0.12±0.68 0.02±0.05 −0.47±0.54
P§=0.025 P=0.800 P=0.197 P=0.672 P=0.230 P=0.395 P=0.933 P=0.933

MAR†: Minimal angle of resolution,

SE‡: Spherical equvalent,

P§: Mann-Whitney test.

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