Comparison of Hyperopic Photorefractive Keratectomy and LASIK

Don Gyung Kim; Jae Ho Choi; Sung Won Kim; Tae Hoon Choi; Chul Myong Choe

doi:10.3341/jkos.2019.60.6.528

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Kim, Choi, Kim, Choi, and Choe: Comparison of Hyperopic Photorefractive Keratectomy and LASIK

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(6): 528-533.

Published online: 17 June 2019

DOI: https://doi.org/10.3341/jkos.2019.60.6.528

Comparison of Hyperopic Photorefractive Keratectomy and LASIK

Don Gyung Kim, MD¹, Jae Ho Choi, MD², Sung Won Kim, MS³, Tae Hoon Choi, MD, PhD¹, Chul Myong Choe, MD, PhD¹

¹Nune Eye Hospital, Seoul, Korea.

²Nune Eye Hospital, Daegu, Korea.

³Department of Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA.

Address reprint requests to Chul Myong Choe, MD, PhD. Nune Eye Hospital, #404 Seolleung-ro, Gangnam-gu, Seoul 06198, Korea. Tel: 82-2-2086-7750, Fax: 82-2-2086-7710, cmchoe@gmail.com

Received 3 May 2018 Revised 11 September 2018 Accepted 17 May 2019

The Korean Ophthalmological Society

(open-access):

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

We compared the results of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for the correction of hyperopia.

Methods

Patients who underwent PRK or LASIK, under +6.00 diopters (D) hyperopia and under −2.00 D astigmatism were included. In total, 21 patients (38 eyes) underwent PRK surgery and 25 patients (41 eyes) underwent LASIK surgery. We compared the visual acuity, refractive error, safety, and efficacy between the two groups.

Results

The manifest refractive spherical equivalent (MRSE) of the PRK and LASIK groups at 1 and 3 months after surgery was significantly different between the two groups (p < 0.05). However, the MRSE was not significantly different at postoperative 6 and 12 months between the two groups. The uncorrected visual acuity (UCVA) of the PRK and LASIK groups at 1 month after surgery was significantly different between the two groups (p < 0.05). However, the UCVA was not significantly different at postoperative 3, 6, and 12 months between the two groups. The best-corrected visual acuity was not significantly different at postoperative 1, 3, 6, and 12 months between the two groups. The safety index was not significantly different between the two groups at postoperative 1, 3, 6, and 12 months. The efficacy index of the PRK group was lower than that of the LASIK group at 1 month after surgery. However, the efficacy index was not significantly different at postoperative 3, 6, and 12 months between the two groups. There was no statistically significant difference between the predictability of the two groups at postoperative 1 year.

Conclusions

After PRK treatment, temporary myopic deviation was observed after 1 month, but there was no significant difference between the two treatments after 3 months of follow-up. In the correction of hyperopia, there was no significant difference between PRK and LASIK in efficacy or safety.

Keywords: Hyperopia, LASIK, Photorefractive keratectomy

Figures and Tables

Figure 1

Changes in spherical equivalent manifest refraction over time after hyperopic PRK and LASIK. PRK = photorefractive keratectomy; LASIK = laser in situ keratomileusis; D = diopter; Pre-op = preoperation.

Figure 2

Uncorrected visual acuity at postoperative 1 year follow up. PRK = photorefractive keratectomy; LASIK = laser in situ keratomileusis.

Figure 3

PRK and LASIK predictability. The percentage of eyes within ± 0.5 D and ± 1.0 D. PRK = photorefractive keratectomy; LASIK = laser in situ keratomileusis; D = diopter; SE = spherical equivalent.

Table 1

Demographics of the surgical patients

Values are presented as mean ± standard deviation (range) unless otherwise indicated.

PRK = photorefractive keratectomy; LASIK = laser in situ keratomileusis; M/F = male/female; UCVA = uncorrected visual acuity; logMAR = the logarithm of minimal angle of resolution; BCVA = best corrected visual acuity; SE = spherical equivalent; D = diopter.

^*t-test, p < 0.05 is statistically significant.

Table 2

Changes in UCVA over time after PRK and LASIK

Values are presented as mean ± standard deviation unless otherwise indicated.

UCVA = uncorrected visual acuity; PRK = photorefractive keratectomy; LASIK = laser in situ keratomileusis; Pre-op = preoperation; logMAR = the logarithm of minimal angle of resolution.

^*t-test, p < 0.05 is statistically significant.

Table 3

Changes in BCVA over time after PRK and LASIK

Values are presented as mean ± standard deviation unless otherwise indicated.

BCVA = best corrected visual acuity; PRK = photorefractive keratectomy; LASIK = laser in situ keratomileusis; Pre-op = preoperation; logMAR = the logarithm of minimal angle of resolution.

^*t-test, p < 0.05 is statistically significant.

Table 4

Comparison in the safety index and efficacy index of PRK & LASIK groups

Values are presented as mean ± standard deviation unless otherwise indicated.

PRK = photorefractive keratectomy; LASIK = laser in situ keratomileusis; POD = post operation day.

^*t-test, p < 0.05 is statistically significant.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

References

1. El-Maghraby A, Salah T, Waring GO 3rd, et al. Randomized bilateral comparison of excimer laser in situ keratomileusis and photorefractive keratectomy for 2.50 to 8.00 diopters of myopia. Ophthalmology. 1999; 106:447–457.

2. He L, Manche EE. Contralateral eye-to-eye comparison of wavefront-guided and wavefront-optimized photorefractive keratectomy: a randomized clinical trial. JAMA Ophthalmol. 2015; 133:51–59.

3. Shortt AJ, Allan BD, Evans JR. Laser-assisted in-situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia. Cochrane Database Syst Rev. 2013; (1):CD005135.

4. Hersh PS, Brint SF, Maloney RK, et al. Photorefractive keratectomy versus laser in situ keratomileusis for moderate to high myopia. A randomized prospective study. Ophthalmology. 1998; 105:1512–1522. discussion 1522–3.

5. Han HS, Song JS, Kim HM. Long-term results of laser in situ keratomileusis for high myopia. Korean J Ophthalmol. 2000; 14:1–6.

6. de Ortueta D, Arba Mosquera S. Topographic stability after hyperopic LASIK. J Refract Surg. 2010; 26:547–554.

7. McGhee CN, Ormonde S, Kohnen T, et al. The surgical correction of moderate hypermetropia: the management controversy. Br J Ophthalmol. 2002; 86:815–822.

8. Azar DT, Primack JD. Theoretical analysis of ablation depths and profiles in laser in situ keratomileusis for compound hyperopic and mixed astigmatism. J Cataract Refract Surg. 2000; 26:1123–1136.

9. Primack JD, Azar DT. Refractive surgery for hyperopia. Int Ophthalmol Clin. 2000; 40:151–163.

10. Sher NA. Hyperopic refractive surgery. Curr opin Ophthalmol. 2001; 12:304–308.

11. Plaza-Puche AB, Yebana P, Arba-Mosquera S, Alió JL. Three-year Follow-up of Hyperopic LASIK using a 500-Hz Eximer Laser System. J Refract surg. 2015; 31:674–682.

12. Shah S, Sheppard AL, Castle J, et al. Refractive outcomes of laser-assisted subepithelial keratectomy for myopia, hyperopia, and astigmatism using a 213 nm wavelength solid-state laser. J Cataract Refract Surg. 2012; 38:746–751.

13. Choi SH, Kim SJ, Kim MK, Wee WR. Short-term clinical results of hyperopic LASEK in Korean patients. J Korean Ophthalmol soc. 2015; 56:1527–1533.

14. Danjoux JP, Kalski RS, Cohen P, et al. Excimer laser photorefractive keratectomy for hyperopia. J Refract Surg. 1997; 13:349–355.

15. Ibrahim O. Laser in situ keratomileusis for hyperopia and hyperopic astigmatism. J Refract Surg. 1998; 14:2 Suppl. S179–S182.

16. Serrao S, Lombardo M. Corneal epithelial healing after photorefractive keratectomy: analytical study. J Cataract Refract Surg. 2005; 31:930–937.

17. Frings A, Richard G, Steinberg J, et al. LASIK and PRK in hyperopic astigmatic eyes: is early retreatment advisable? Clin Ophthalmol. 2016; 10:565–570.

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