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J. Gaytan Melicoff, O. Baca, R. Velasco, D. Viggiano, R. Loyo; LASEK: Laser Assisted Sub-epitelial Keratectomy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2652.
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Purpose: To evaluate the outcome of LASEK. Methods: A prospective, longitudinal and descriptive study was done. Patients with high and moderate myopia with or without astigmatism, with thin corneas, with small palpebral fissures or with professional risk (eye exposure), were included. Patients with previous ocular surgery or contact lense wear in last 3 weeks, were excluded. Complete ophthalmologic exam, PRK nomogram with Chiron Technolas 217 excimer laser, and surgical technique similar to Camellin, was done. Post operative flollow up (uncorrected visual acuity, best corrected visual acuity, paquimetry, axial topography and biomicroscopy) was made at 1 day, 1 week, 1 month and 3 months. Hanan's scale was used to evaluate the presence of haze. Results: 24 eyes of 13 patients were included, mean age was 28.5 years (range 19-50 years) with pre operative spherical equivalent mean –9.47D. (range –6.00 to –13.25 D.). Pre operative paquimetry was mean 539 micras, post operative paquimetry mean 362 micras. Uncorrected visual acuity (UVA) was 20/100 or less in all patients except one (20/80); all the patients had best corrected visual acuty of 20/30 or better. One month after surgery: UVA of 20/50 or better (79.1%), UVA of 20/30 or better (66.6%) and UVA of 20/80 (12.5%). Mean post surgical sphere +0.50 D. (range –3.25 to +3.75). Mean post surgical cylinder –0.89 D. (range –0.50 to –2.50). After 3 months, 66.6% with UVA of 20/30 or better, and finally 22.2% with UVA of 20/80. Mean post surgical sphere –0.46 D. (range –3.00 D. to +4.00 D.). 2 eyes without refractive correction. Mean post surgical cylinder -1.70 D. (range –1.25 to –3.25). Evaluation of haze at 1 month follow up: grade 0.5-1 (75%), grade 2 (4.1%), and 20.9% with transparent corneal epithelium. Conclusions: This refractive procedure did not need a microkeratome, there were none trans operative complications but we had some cases of haze and hypercorrection in the post operative. The procedure requiered more surgical training than LASIK. The experience and predictability of LASEK is low; soo it is necessary to use a new nomogram instead of the one for PRK. The procedure has specific indications and could be good for patients with moderate to high myopia and thin corneas.
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