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MC Rojas, EE Manche; Analysis of the Efficacy, Predictability, and Safety of LASEK . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4132.
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Purpose: To evaluate the efficacy, predictability, and safety of laser subepithelial keratomileusis (LASEK) for the treatment of myopia and myopic astigmatism. Methods: Retrospective analysis of 42 eyes that underwent LASEK for myopia and myopic astigmatism using the Bausch & Lomb Technolas 217 excimer laser. Primary outcome variables including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and complications were evaluated. Vector analysis was performed on eyes that received astigmatic correction. Results: At the 3 month follow-up, 24 eyes were available for analysis. Mean preoperative spherical equivalent was reduced from -7.10 2.48 diopters (D) (range, -1.63 to -11.38 D) to +0.22 0.50 D (range, -0.50 to +0.75 D) after LASEK (p<0.001). UCVA was 20/20 or better in 56.5% of eyes, and 20/40 or better in 100% of eyes. Seventy-four percent of eyes were within 0.5 D of emmetropia, and 91.3% were within 1.0 D of emmetropia. No eyes lost 2 or more lines of BSCVA. On postoperative day 1, 54.2% reported no pain, 29.1% reported minimal pain, and 16.7% reported pain. At postoperative month 3, 26.1% had minimal corneal haze. UCVA in these eyes ranged from 20/15 to 20/25. Two eyes had monocular diplopia secondary to residual astigmatism that resolved with refractive error correction. Vector analysis showed an index of success of 0.12 at postoperative month 3, indicating an 88% success rate in achieving the astigmatic surgical correction. Conclusions: LASEK for the treatment of myopia and myopic astigmatism is an effective, predictable, and safe procedure. No eyes had more than trace haze which was visually insignificant at the 3 month postoperative visit. Long-term follow-up is needed to assess stability. Comparison to laser in-situ keratomileusis and photorefractive keratectomy may further determine the advantages and disadvantages of LASEK over other refractive procedures.
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