Long-term Outcome of Combined Laser-assisted Subepithelial Keratomileusis and Accelerated Corneal Crosslinking for Myopia

Purpose: We compared clinical outcomes between combined laser-assisted subepithelial keratomileusis and accelerated collagen cross-linking (Avedro-LASEK), and LASEK alone. Methods: This retrospective study analyzed 38 eyes of 19 patients who had undergone Avedro-LASEK, and 34 eyes of 17 patients who received LASEK alone. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), keratometry, and corneal inflammation were evaluated preoperatively, and at 1 week, 1, 3, and 6 months, and 1 and 2 years after surgery. Results: The Avedro-LASEK group had a higher preoperative SE (p < 0.05) and thinner central cornea compared with the control group (p < 0.05). There was no significant difference in UDVA, SE stability or keratometry between the two groups during the 2-year follow-up period. At the 2-year follow-up, the SE was +/- 0.25 diopter (D) in 92% of the Avedro-LASEK patients and +/- 0.5 D in 90.2% of the LASEK patients. Both groups showed high levels of refractive predictability. There was no significant difference between the flat K (p = 0.38) and steep K (p = 0.56) rates over time between the two groups. Corneal haze was observed in 21% of eyes in the Avedro-LASEK group, but neither decreased vision nor ectasia was observed during the follow-up period. Conclusions: During the 2-year follow-up period, there were no significant differences in any parameters between the Avedro-LASEK and LASEK patients, and both procedures are considered effective for myopia correction because of their stability and effectiveness.