[Excimer laser subepithelial ablation (ELSA) or laser epithelial keratomileusis (LASEK) - a new kerato-refractive procedure for myopia. Surgical technique and first clinical results on 24 eyes and 3 months follow-up].
BACKGROUND
Laser epithelial keratomileusis (LASEK) is a new keratorefractive surgical procedure to treat myopia and possibly other refractive errors, which combines the advantages while eliminating the disadvantages of both PRK (pain, corneal haze) and LASIK (flap complications, interface complications). Our results with LASEK are very promising and because this technique is currently not very popular in Germany we here with introduce the surgical technique and our first clinical results.


METHODS
We treated 24 eyes (18 patients) by LASEK. The preoperative myopia was between - 1.50 and - 6.00 D with an astigmatism less than 1.00 D. Surgery starts with an incision in the epithelium by using a special microtrephine. After the application of 20 % ethanol for 20 seconds a hinged epithelial flap is created and the laser ablation performed with a Keracor 117 excimer laser. Finally, the epithelial flap is repositioned and secured using a bandage contact lens and artificial tears for 3 days.


RESULTS
In all eyes the creation of the epithelial flap and its repositioning presented no problems. None of the eyes showed any postoperative epithelial instability. However, one eye lost the contact lens and the epithelial flap during the first postoperative day. Postoperatively, none of the patients complained of significant pain; however, the contact lens caused some foreign body sensation. After 3 months all eyes were within +/- 1.0 D and 20/24 eyes (84 %) within +/- 0.50 D of emmetropia (spherical equivalent). None of the eyes showed significant haze.


CONCLUSIONS
Although, the number of treated eyes is small and the postoperative follow-up is short LASEK seems to be an effective and safe procedure for the treatment of myopia.
Lohmann
Chris P
CP
Universitäts-Augenklinik Regensburg, Germany. lohmann@eye-regensburg.de
Winkler Von Mohrenfels
Christoph
C
Gabler
Bernhard
B
Hermann
Wolfgang
W
Müller
Michael
M
D000328:Adult; D001251:Astigmatism / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications / Q000209:etiology*; D012029:Refraction, Ocular
Excimer Laser Subepitheliale Ablation (ELSA) bzw. Laser Epitheliale Keratomileusis (LASEK) - Ein neuartiges refraktiv-chirurgisches Verfahren zur Myopiekorrektur. Operationstechnik und erste klinische Ergebnisse an 24 Augen und nach 3 Monaten.