Comparison of Short Term Clinical Results Between LASEK and Epi-LASIK

Seung Kyu Lee; Sun Woong Kim; Tae Im Kim; Hyung Kuen Lee; Eung Kweon Kim; Kyoung Yul Seo

doi:10.3341/jkos.2008.49.3.409

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Lee, Kim, Kim, Lee, Kim, and Seo: Comparison of Short Term Clinical Results Between LASEK and Epi-LASIK

Original Article

J Korean Ophthalmol Soc 2008;49(3):409-414.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.3.409

Comparison of Short Term Clinical Results Between LASEK and Epi-LASIK

Seung Kyu Lee, M.D.¹, Sun Woong Kim, M.D.², Tae Im Kim, M.D.¹, Hyung Kuen Lee, M.D.¹, Eung Kweon Kim, M.D.¹, Kyoung Yul Seo, M.D.¹

¹The Institute of Vision Research, Department of Ophthalmology, Yonsei University, College of Medicine, Seoul, Korea

²Department of Ophthalmology, Soonchunhyang University, College of Medicine, Seoul, Korea

Address reprint requests to Kyoung Yul Seo, M.D. Department of Ophthalmology, Yonsei University College of Medicine #134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea Tel: 82-2-2228-3570, Fax: 82-2-312-0541, E-mail: seoky@yumc.yonsei.ac.kr

Received 7 March 2007 Accepted 21 September 2007

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 short-term clinical results of LASEK and epi-LASIK.

Methods

Fifteen subjects (30 eyes) underwent uncomplicated LASEK on one eye and uncomplicated epi-LASIK on the other eye by a single surgeon, and uncorrected visual acuity, refractive change, postoperative pain, and postoperative satisfaction were compared at postoperative week one, at one month, and at three months.

Results

Postoperative uncorrected visual acuities were 0.68±0.20, 0.96±0.22, and 1.05±0.17 for LASEK and 0.75±0.21, 0.92±0.14, and 1.01±0.21 for epi-LASIK at one week, one month, and three months, respectively. Epi-LASIK showed faster improvement in visual acuity at one week, while LASEK showed faster improvement afterward. However, no statistical significance was found. Spherical equivalet of LASEK was −0.66±1.28D and that of epi-LASIK was −0.61±0.92D at postoperative week one, implying faster refractive recovery for epi-LASIK, but after one month, LASEK was faster in refractive recovery and all these changes were not statistically significant. Durations of postoperative pain were 3.13±1.25 days for LASEK and 3.02±1.32 days for epi-LASIK. Pain scores (0∼10 point scale), however, were also lower for LASEK by 0.33 point, 0.57 point, and 0.45 point for postoperative day 1, 2, and 3, respectively. No statistical significance was noted in either pain duration or pain score. When asked for overall satisfaction, six subjects preferred LASIK, four subjects preferred epi-LASIK, and five subjects showed no preference.

Conclusions

Both LASEK and epi-LASIK are effective for surgical correction of myopia, and no significant difference in visual recovery, refractive change or degree of postoperative pain was noted in this study.

Keywords: Epi-LASIK, LASEK, Surface ablation

References

1. Trokel SL, Srinivasan R, Braren B. Excimer laser surgery of the cornea. Am J Ophthalmol. 1983; 96:710–5.

2. Seiler T, Holschbach A, Derse M, et al. Complications of myopic photorefractive keratectomy with the excimer laser. Ophthalmology. 1994; 101:153–60.

3. Gartry DS, Kerr Muir MG, Marshall J. Excimer laser photorefractive keratectomy: 18 months follow-up. Ophthalmology. 1992; 99:1209–19.

4. Seiler T, Wollensak J. Myopic photorefractive keratectomy with excimer laser: one-year follow-up. Ophthalmology. 1991; 98:1156–63.

5. Wang Z, Chen J, Yang B. Comparison of laser in situ keratomileusis and photorefractive keratectomy to correct myopia from 1.25 to 6.00 diopters. J Refract Surg. 1997; 13:528–34.

6. Hersh PS, Brint SF, Maloney RK, et al. Photorefractive keratectomy versus laser in situ keratomileusis for moderate to high myopia. Ophthalmology. 1998; 105:1513–23.

7. Kamm O. The relation between structure and physiological action of the alcohols. J of the American Pharmaceutical Association. 1921; 10:87–92.

8. Kim SY, Sah WJ, Lim YW, Hahn TW. Twenty percent alcohol toxicity on rabbit corneal epithelial cells: electron microscopic study. Cornea. 2002; 21:388–92.

9. Abad JC, An B, Power WJ, et al. A prospective evaluation of alcohol-assisted versus mechanical epithelial removal before photorefractive keratectomy. Ophthalmology. 1997; 104:1566–74.

10. Abad JC, Talamo JH, Vidaumi-Leal J, et al. Dilute ethanol versus mechanical debridement before photorefractive keratectomy. J Cataract refract Surg. 1996; 22:1427–33.

11. Lee JB, Seong GJ, Lee JH, et al. Comparison of laser epithelial keratomileusis and photorefractive keratectomy for low to moderate myopia. J Cataract Refract Surg. 2001; 27:565–70.

12. Carones F, Fiore T, Brancato R. Mechanical versus alcohol epithelial removal during photorefractive keratectomy. J Refract Surg. 1999; 15:556–62.

13. Stein HA, Stein RM, Price C, Salim GA. Alcohol removal of the epithelium for excimer laser ablation: outcomes analysis. J Cataract Refract Surg. 1997; 23:1160–3.

14. Kim HJ, Joo CK. Clinical results of Laser epithelial keratomileusis and Laser in situ keratomileusis for moderate and high myopia. J Korean Ophthalmol Soc. 2003; 44:1159–64.

15. Pallikaris IG, Naoumidi II, Kalyvianaki MI, et al. Epi-LASIK: Comparative histological evaluation of mechanical and alcohol-assisted epithelial separation. J Cataract Refract Surg. 2003; 29:1496–501.

16. Kwon HL, Kim KI, Koo BS, Park HR. Short Term Clinical Results of Laser Epithelial Keratomileusis and epi-Laser in Situ Keratomileusis for Moderate and High Myopia. J Korean Ophthalmol Soc. 2005; 10:1711–7.

17. O' Doherty M, Kirwan C, O' Keeffe M, O' Doherty J. Postoperative Pain Following epi-LASIK, LASEK, and PRK for Myopia. J Refract Surg. 2007; 23:133–8.

18. Lee SB, Chung MS. Advanced Surface Ablation-Photorefractive Keratectomy (ASA-PRK): Safety and Clinical Outcome for the Correction of Mild to Moderate Myopia with a Thin Cornea. J Korean Ophthalmol Soc. 2006; 47:1274–86.

Table 1.

Baseline characteristics of eyes for LASEK and epi-LASIK

Characteristics	LASEK^*	epi-LASIK^†	P-value
Age, mean (years)±SD^‡	27±4.6
Gender (male/female)	3/12
Preoperative SE^§, mean (D^∏)±SD	−4.30±1.55	−4.32±1.70	0.825
Preoperative UCVA^#, mean±SD	0.10±0.10	0.09±0.10	0.178
Keratometry, mean (D)±SD	42.6±1.2	42.5±1.2	0.131
Pachymetry, mean (µm)±SD	558.7±35.8	558.1±36.0	0.527

^* LASEK=laser epithelial keratomileusis; equivalent

^∏ D=diopters

^＃ UCVA=uncorrected visual acuity; Paired t-test.

^† epi-LASIK=epi-laser in situ keratomileusis

^‡ SD=standard deviation

^§ SE=spherical

Table 2.

Mean uncorrected visual acuities after LASEK and epi-LASIK at different postoperative periods

	Mean UCVA^‡ at postoperative periods±SD^§
	1 week	1 month	3 months
LASEK^*	0.68±0.20	0.96±0.22	1.05±0.17
epi-LASIK^†	0.75±0.21	0.92±0.14	1.01±0.21
P-value^∏	0.380	0.445	0.691

^* LASEK=laser epithelial keratomileusis; laser in situ keratomileusis; acuity

^§ SD=standard deviation

^∏ Pared t-test.

^† epi-LASIK=epi-

^‡ UCVA=uncorrected visual

Table 3.

Mean spherical equivalents after LASEK and epi-LASIK at different postoperative periods

	Mean SE^‡ at postoperative periods±SD^§
	1 week	1 month	3 months
LASEK^*	−0.66±1.28	−0.11±0.55	−0.16±0.39
epi-LASIK^†	−0.61±0.92	−0.12±0.68	−0.17±0.48
P-value^∏	0.886	0.860	0.916

^* LASEK=laser epithelial keratomileusis; laser in situ keratomileusis

^‡ SE=spherical equivalent

^§ SD= standard deviation

^∏ Pared t-test.

^† epi-LASIK=epi-

Table 4.

Comparison of the duration of postoperative pain and the period of bandage contact lens removal after LASEK and epi-LASIK

	Mean postoperative days±SD^§
	Pain duration	BCL^‡ removal
LASEK^*	3.13±1.25	4.73±1.90
epi-LASIK^†	3.02±1.32	4.07±1.33
P-value^∏	0.334	0.272

^* LASEK=laser epithelial keratomileusis; laser in situ keratomileusis

^§ SD=standard deviation

^∏ Pared t-test.

^† epi-LASIK=epi-

^‡ BCL=bandage contact lens

Table 5.

Comparison of subjective pain scores after LASEK and epi-LASIK at different postoperative periods

	Mean pain scores^‡ at postoperative periods±SD^§
	POD^＃ 1	POD 2	POD 3
LASEK^*	7.07±2.22	5.57±1.87	3.82±2.60
epi-LASIK^†	7.40±2.06	6.14±2.03	4.27±2.65
P-value^∏	0.313	0.135	0.138

^* LASEK=laser epithelial keratomileusis

^‡ NPIS (The Numerical Pain laser in situ keratomileusis; Intensity Scale), 0 being no pain and 10 being the worst

^∏ Pared t-test

^§ SD=standard deviation; imaginable pain

^＃ POD=postoperative day.

^† epi-LASIK=epi-

Table 6.

Overall postoperative satisfaction with preference for surgical methods after LASEK and epi-LASIK

	Number of patients (%)
LASEK* Better	6 (40)
epi-LASIK^† Better	4 (27)
No difference	5 (33)

^* LASEK=laser epithelial keratomileusis; laser in situ keratomileusis.

^† epi-LASIK=epi-

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