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B Gabler, C Winkler von Mohrenfels, CP Lohmann; Laser epithelial keratomileusis (LASEK): Correction of moderate (-6,0 D) and higher (-12,0 D) myopia - 6 months clinical results . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4131.
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Purpose: In corneal refractive surgery photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) are well established methods to correct myopia. A new technique is the Laser epithelial keratomileusis (LASEK), where a vital epithelial flap is created. First studies show that LASEK seems to at least partially eliminate the disadvantages of PRK (pain, haze, slow recovery of vision) and LASIK (flap- and interface-problems, keratectasia) and combines their advantages. Particularly in higher myopia, where PRK is associated with increased risk of haze and regression and where LASIK may be contraindicated because of insufficient residual stromal thickness, LASEK could be a very good alternative with its superficial ablation and suppressed wound healing/haze. Method: We performed LASEK in 100 eyes with spherical equivalent refraction (SE) of less than -6,0 D (moderate myopia) and in 60 eyes with SE of -6,0 to -12,0 D (high myopia) using 20% ethanol for 20 seconds and the Keracor 217 excimer laser (Chiron Technolas, USA). Currently the 6-month follow up is completed in 45 and 40 eyes resp. Results: In both groups no eye lost 2 lines of BCVA or more. For higher myopia 72% were within ±0,5 D and 82% within ±1,0 D after 6 months compared to 72% (±0,5 D) and 88% (±1,0 D) in moderate myopia. In most eyes, no or only faint haze was seen (no difference between the groups, maximum individual haze: grade 1). UCVA was ≷= 20/40 in 95% (100%) and ≷= 20/20 in 57% (68%) six months after LASEK for high myopia (moderate myopia). Maximum regression was -1,75 D. Conclusion: LASEK is a safe method to correct high myopia. Haze is absent or low-grade even in the high myopia group. Although LASEK for higher myopia is not as precise as for low and moderate myopia, our LASEK refractive results for higher myopia are comparable to PRK- and LASIK-results of other groups. As LASEK is associated with little pain, little haze, a relatively rapid visual recovery and a stromal cut is not required, we regard LASEK not only as an alternative to PRK, but also to LASIK for both moderate and high myopia.
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