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JR Padousis, S Choudhri, M Qazi, JS Pepose; Visual and Refractive Outcomes in LASEK Patients Compared With LASIK Patients . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4136.
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Purpose: To compare three month refractive surgery outcomes between patients undergoing LASEK to matched LASIK controls. Method: Charts from 59 consecutive LASEK patients were reviewed. Charts from 1950 consecutive LASIK patients were also reviewed to find refraction-matched LASIK controls for each LASEK patient included in the study. LASIK controls were selected on the basis pre-operative manifest refractions (sphere within 1 D of LASEK patient and cylinder within 0.5 D) and age of patient (age within two years of LASEK patient). Monovision corrections, hyperopic corrections, patients lacking three month post-operative refractions, and eyes with pre-existing pathology or pre-operative best corrected vision less than 20/25 were excluded from both groups. Three LASEK patients were excluded from the study since no suitable LASIK controls were found. All surgeries were performed with the VISX STAR S2 or S3 excimer laser system. Results: The final data set included three month refractive surgery outcomes for 21 LASEK patients and 112 LASIK controls. The pre-operative spherical equivalents were similar in both groups, with a mean of -8.8 ± 1.66 D in the LASEK group and -8.3 ± 1.48 D in the LASIK group (p=.17). The percentage of patients within 0.5 D of emmetropia was 52% for LASEK patients and 40% for LASIK patients, with 62% of LASEK patients and 63% of LASIK patients within 1 D of emmetopia. The mean post-operative spherical equivalent for the LASEK group was +0.56 ± 1.03 D and ranged from -1.375 D to 3.5 D. For the LASIK group, the mean spherical equivalent post-operatively was -0.88 ± .82 D and ranged from -3.25 D to .75 D. This difference was statistically significant (p<0.01), with a tendency for over correction in the LASEK group. There was no statistically significant difference in post-operative uncorrected visual acuity between groups (LogMar .10 ± .24 for LASEK patients vs. .16 ± .23 for LASIK patients, p=.28). Neither group experienced any significant change in best corrected visual acuity post-operatively (LogMar .03 ± .06 for LASEK patients vs. .01 ± .06 for LASIK patients), and no complications were observed. Conclusion: Compared with matched LASIK controls, LASEK appears to provide similar three month visual outcomes. LASEK patients did tend to be slightly overcorrected, and a nomogram adjustment may be indicated. LASEK appears to be a suitable alternative to LASIK, particularly for patients with thin or steep corneas.
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