One-year results of butterfly laser epithelial keratomileusis.
OBJECTIVE
To evaluate the risks, complications, and refractive results at 1 year after modified laser epithelial keratomileusis (Butterfly LASEK).


METHODS
In a non-randomized prospective study of 773 eyes (452 patients; mean age 34.3 +/- 16.5 years, mean preoperative spherical equivalent refraction -5.30 +/- 3.70 D; mean sphere -4.80 +/- 3.60 D; mean cylinder -1.00 +/- 1.40 D; range -22.50 to +5.50 D), we used a modified LASEK technique and evaluated complications and refractive results at 1 year. The technique is based on the formation of the epithelial flap utilizing alcohol (20% diluted solution applied on the epithelium for 5 to 30 seconds), paracentral abrasion, blunt dissection of the epithelium from the underlying plane; the epithelium is then separated by means of a specially designed retractor. Ablation was performed with a Nidek EC-5000 excimer laser, followed by smoothing and repositioning of the epithelial flap.


RESULTS
After 1 year, we analyzed the results of 542 (70.1%) treated eyes with the following outcome: mean postoperative spherical equivalent refraction -0.20 +/- 1.40 D; mean sphere -0.10 +/- 1.30 D; mean cylinder -0.10 +/- 0.60 D; range -2.50 to +0.75 D. In 83.0% of treated eyes, achieved refraction was within +/-0.50 D of planned correction, with uncorrected visual acuity greater than or equal to 1.2 in 19.0% of treated eyes, greater than or equal to 1.0 in 56.0%, and greater than or equal to 0.8 in 19%. Concerning visual acuity, 0.3% of eyes lost 1 line, 49.8% of eyes had no change; 41.8% gained 1 line, 9.8% gained 2 lines, and 1.6% gained more than 2 lines.


CONCLUSIONS
One-year results of this preliminary study showed that Butterfly LASEK was easy to perform, safe, and led to excellent long-term refractive results.
Vinciguerra
Paolo
P
Department of Ophthalmology, Istituto Clinico Humanitas, Rozzano, Milano, Italy. paolo.vinciguerra@humanitas.it
Camesasca
Fabrizio I
FI
Randazzo
Alessandro
A
D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D004847:Epithelial Cells / Q000502:physiology; D019573:Epithelium, Corneal / Q000601:surgery*; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012029:Refraction, Ocular; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity