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. 2014 Jul;28(3):214-9.
doi: 10.1016/j.sjopt.2013.10.002. Epub 2013 Oct 11.

Comparison of LASEK, mechanical microkeratome LASIK and Femtosecond LASIK in low and moderate myopia

Khalid AlArfaj  1 , Mohamed M Hantera  2
Affiliations

Comparison of LASEK, mechanical microkeratome LASIK and Femtosecond LASIK in low and moderate myopia

Khalid AlArfaj et al. Saudi J Ophthalmol. 2014 Jul.

Abstract

Purpose: We conducted a prospective study to determine the best treatment option for patients with low-to-moderate spherical myopia or myopic astigmatism who are considered equally eligible for LASEK with mitomycin-C (MMC) and LASIK with either mechanical microkeratome or femtosecond laser flap creation.

Methods: Forty-six adult patients (86 eyes) who underwent LASEK with MMC (16 patients, 31 eyes), and mechanical microkeratome LASIK (13 patients, 23 eyes) or Femtosecond LASIK (17 patients, 32 eyes) were assessed for clinical outcomes 1, 3 and 6 months post-operatively.

Results: Six months after surgery, all eyes in all three groups were within 1 D of the intended refractive change. UCVA 20/20 or better was achieved in 96% of eyes undergoing LASEK with MMC 88% of eyes in the mechanical microkeratome LASIK and 72% of eyes in the Femtosecond LASIK group at 6 months. Mean spherical equivalent was -0.12 ± 0.22 D, -0.09 ± 0.28 D and -0.25 ± 0.28 D in the three groups, respectively (p = 0.077). Patients in the LASEK with MMC group had less high order aberrations at 3 and 6 months compared to the two LASIK groups. None of the three procedures were associated with early- or late-onset complications or loss of 2 or more lines after surgery.

Conclusions: After an initially slower visual improvement, LASEK with MMC, and to lesser extent, LASIK with mechanical microkeratome, produced better visual acuity and less corneal aberrations compared to Femtosecond LASIK at 3 and 6 months after surgery. These observations deserve further investigation in a randomized controlled trial.

Keywords: Femtosecond laser; LASEK; LASIK; Mechanical microkeratome; Myopia.

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Figures

Figure 1
Figure 1
Stability of the achieved correction (spherical equivalent) over 6 months of follow-up.
Figure 2
Figure 2
Attempted vs. achieved correction of spherical equivalent (SEQ; predictability) at 6 months after refractive surgery.
Figure 3
Figure 3
Mean root mean square of high order aberrations over 6-months of follow-up.
Figure 4
Figure 4
Strehl ratio over 6-months of follow-up.
See this image and copyright information in PMC

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