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J. D. Edwards, K. S. Bower, D. A. Sediq, C. D. Coe, C. P. Kuzmowych, J. B. Eaddy, L. Peppers; Comparison of Visual Outcomes After Epithelial Laser-Assisted Keratomileusis (Epi-Lasik) and Photorefractive Keratectomy (PRK). Invest. Ophthalmol. Vis. Sci. 2009;50(13):553.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate visual results following Epi-lasik compared to photorefractive keratectomy (PRK).
Prospective study of 294 active duty US Army soldiers age 21 or over, who underwent Epi-lasik (298 eyes) or PRK (290 eyes) for low to moderate myopia or myopic astigmatism. Epi-lasik was performed with the Amadeus II epikeratome and PRK with the Amoils rotary epithelial brush. All ablations were performed using the LADARVision 6000 excimer laser system with emmetropia as the post-op target. Testing pre-op and at 1M, 3M, 6M and 12M post-op included uncorrected visual acuity (UCVA), manifest refraction, best spectacle-corrected visual acuity (BSCVA), 5% and 25% low contrast visual acuity (LCVA) and corneal haze. Statistical analysis was performed using SPSS software version 15.0 using either the Student T-test for normally distributed data or the Mann-Whitney test when there were several measured variables.
The mean age of Epi-lasik patients was 34.3±8.2 vs. 34.1±7.4 for PRK patients (p=0.807). The mean pre-op manifest spherical equivalent (MSE) was -2.97±1.19D (range -1.00 to -6.25) for Epi-lasik vs. -2.94±1.06D (-1.00 to -6.00) for PRK (p=0.819). Post-op UCVA met or exceeded pre-op BSCVA in 83.6% of Epi-lasik compared to 71.7% of PRK patients at 6M (p=0.027). UCVA of 20/15 or better was more likely following Epi-lasik compared to PRK at 1M (26.2% vs. 17.8%, p=0.032), 3M (63.5% vs. 49.3%, p=0.000), 6M (77.8% vs. 57.9%, p=0.000) and 12M (76.2% vs. 61.9%, p=0.001). LCVA (5 and 25%) was comparable between the treatment groups at all time points except 5% LCVA at 12M, which was unchanged or better than pre-op in 93.9% of Epi-lasik patients vs. 78.3% of PRK patients (p=0.000). There was no difference between the two procedures in BSCVA, predictability (MSE ±0.5 D or ±1.0D), or clinically significant corneal haze at any time point.
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