Alcohol- vs hypertonic saline-assisted laser-assisted subepithelial keratectomy.
OBJECTIVE
To evaluate the predictability and safety of hypertonic saline (5% sodium chloride) [correction]-assisted laser-assisted subepithelial keratectomy (HS-LASEK) vs 20% alcohol-assisted LASEK (A-LASEK).


METHODS
American Laser Medical Center, Rishon Le-Zion, Israel.


METHODS
Fifty-two consecutive eyes (26 patients) were randomized to HS-LASEK (30 eyes) and A-LASEK (22 eyes) groups. The patients' eyes were examined, refracted, and photographed at 1 day, 5 days, 2 weeks, and 1 month postoperatively by a masked physician. Corneal topography and confocal examination were performed before and 1 month after surgery.


METHODS
The predictability, accuracy, and visual recovery of HS-LASEK vs A-LASEK in the first postoperative month.


RESULTS
The accuracy of HS-LASEK was similar and sometimes better than A-LASEK. Two weeks after surgery, 17 eyes (57%) in the HS-LASEK group and 10 eyes (46%) in the A-LASEK group were within +/- 0.5 diopter of the intended refractive correction (P<.05). At all time points eyes in the HS-LASEK group had better best-corrected visual acuity than eyes in the A-LASEK group, although the uncorrected visual acuity was similar. Eighteen (61%) of the HS-LASEK-treated eyes and 12 (55%) of the A-LASEK-treated eyes had an epithelial defect after surgery. The HS-LASEK-treated eyes had significantly larger epithelial defects. The resolution of the defects was faster in the HS-LASEK-treated eyes (mean +/- SD, 4.5 +/- 0.4 days vs 5.8 +/- 0.2 days, P = .002). The subepithelial scar was thicker in A-LASEK-treated eyes.


CONCLUSIONS
Hypertonic saline-assisted LASEK provides good postoperative accuracy, safety, and a similar rate of complications. In view of recent evidence regarding the epithelial toxic effects of alcohol, HS-LASEK might be a better treatment alternative.
Hazarbassanov
Rossen
R
American Lasers Medical Center, Rishon Le-Zion, Israel.
Ben-Haim
Oded
O
Varssano
David
D
Grinbaum
Aharon
A
Kaiserman
Igor
I
D000328:Adult; D019781:Corneal Topography; D019573:Epithelium, Corneal / Q000473:pathology; D000431:Ethanol / Q000008:administration & dosage*; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted / Q000379:methods*; D018613:Microscopy, Confocal; D010781:Photography; D012029:Refraction, Ocular; D015203:Reproducibility of Results; D012449:Safety; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D014792:Visual Acuity
D012462:Saline Solution, Hypertonic; D000431:Ethanol