Long term results of Epi-LASIK and LASEK for myopia

Purpose: To evaluate the long term clinical and confocal results of mechanical (Epi-LASIK) versus alcohol-assisted laser epithelial keratomileusis (LASEK) for correction of myopia. Setting: Gazi University Medical School, Department of Ophthalmology, Ankara, Turkey. Design: Retrospective study. Methods: Twenty-two eyes treated with LASEK and twenty eyes treated with Epi-LASIK were evaluated with a mean follow-up duration of 45 months. Mechanical separation of the epithelium was performed with Lasitome epithelial separator, and alcohol-assisted separation with 25 s application of 18% alcohol. Laser ablation was performed with the ESIRIS laser. All patients were examined daily until epithelial closure; at 1, 3, 6, and 12 months; and every year subsequently. Main outcome measures were uncorrected visual acuity (UCVA), manifest refraction, haze, and gray scale value in confocal microscopy, efficacy and safety indexes. Results: Preoperative myopic spherical equivalent refraction was -4.65 +/- 1.74 D in the LASEK and -3.87 +/- 1.30 D in the Epi-LASIK-treated eyes (p = 0.36). Of both LASER and Epi-LASIK-treated eyes, 95% achieved 20/25 or better final UCVA. The grade of haze and mean gray scale value in confocal microscopy were similar in LASEK and Epi-LASIK-treated eyes at all postoperative periods. The efficacy index was 0.94 in LASER group and 0.96 in Epi-LASIK group (p = 0.44). The safety index was 1.01 in LASER group and 1.02 in Epi-LASIK group (p = 0.42). Conclusions: Both LASEK and Epi-LASIK offer safe and effective correction of myopia in the long term. Crown Copyright (C) 2013 Published by Elsevier Ltd on behalf of British Contact Lens Association. All rights reserved.