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Meta-Analysis
. 2025 Mar 18;25(1):140.
doi: 10.1186/s12886-025-03956-6.

Meta-analysis: clinical outcomes of laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) in hyperopia

Mohammed Naji Almutairi  1 , Abdullrahman M Alshehri  2 , Abdulrahman Y Alhoumaily  3 , Osamah Alnahdi  2 , Mohammed A Taha  4   5   6 , Shiji Gangadharan  4   5   6
Affiliations
Meta-Analysis

Meta-analysis: clinical outcomes of laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) in hyperopia

Mohammed Naji Almutairi et al. BMC Ophthalmol. .

Abstract

Background: To evaluate differences in clinical outcome, safety, and efficacy of photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) in the correction of hyperopic refractive errors.

Methods: We have adhered to PRISMA criteria in this systematic review, which is registered with PROSPERO (CRD42023469543). Our search with studies comparing PRK and LASIK for hyperopia was conducted through the databases PubMed, EMBASE, Web of Science, and the Cochrane Library. We used the Cochrane method to assess bias and evaluated variables like uncorrected distance visual acuity and mean spherical equivalent. Using fixed- or random-effects models, a meta-analysis was performed using RevMan 5.4 for evaluating heterogeneity and significance. Sensitivity analysis addressed the causes of heterogeneity to assure stability.

Results: We included 6 articles (419 participants, 585 eyes) in this review five were retrospective and 1 case-series. The final mean refractive SE (WMD, -0.05; 95% confidence interval [CI], 0.42 to 0.31; P = 0.06). patients achieving uncorrected distance visual acuity (UDVA) of 20/20 or better (OR, 0.58; 95% CI, 0.39-0.78; P = 0.33). final UDVA of 20/40 or better (OR, 1.40; 95% CI, 0.65-3.02; P = 0.81) were analyzed.

Conclusions: In this meta-analysis, LASIK had no significant benefits over PRK in relation to clinical outcomes. Less corneal haze was observed in LASIK-treated eyes at 1 to 3 months after surgery.

Keywords: Hyperopia; LASIK; Laser-assisted in situ keratomileusis; PRK; Photorefractive keratectomy; Refractive surgery.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of study selection
Fig. 2
Fig. 2
“Risk of bias summary "review authors' judgements about each risk of bias item for each included study
Fig. 3
Fig. 3
“Risk of bias graph "review authors' judgements about each risk of bias item presented as percentages across all included studies
Fig. 4
Fig. 4
Forest plot of preoperative mean refractive spherical equivalent between photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) procedures
Fig. 5
Fig. 5
Forest plot of postoperative mean refractive spherical equivalent between photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) procedures at 1 month
Fig. 6
Fig. 6
Forest plot of post operative spherical equivalent between photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) procedures at 6 months
Fig. 7
Fig. 7
Forest plot of postoperative mean refractive spherical equivalent between photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) procedures at last follow up
Fig. 8
Fig. 8
Forest plot of post operative uncorrected visual acuity (UCVA) 20/20 or better between photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) Procedures
Fig. 9
Fig. 9
Forest Plot of Post operative uncorrected visual acuity (UCVA ) 20/40 or better between photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) procedures
Fig. 10
Fig. 10
Forest Plot of post operative fixed Refraction within ±0.5D between photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) procedures
Fig. 11
Fig. 11
Forest Plot of post operative random refraction within ±0.5D between photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) Procedures
Fig. 12
Fig. 12
Forest Plot of post operative refraction within ±1D between photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) procedures
Fig. 13
Fig. 13
Forest plot of post operative haze between photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) procedures
Fig. 14
Fig. 14
Forest Plot of the comparison of the loss of two or more lines of best corrected visual acuity (BCVA) between PRK and LASIK procedures
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