title: Laser subepithelial keratomileusis for the correction of high myopia with the Schwind ESIRIS scanning spot laser.
abstract: OBJECTIVE
  To investigate the efficacy of laser subepithelial keratomileusis (LASEK) for the correction of high myopia with the Schwind ESIRIS scanning spot laser (Schwind eye-tech-solutions Gmbh & Co, Kleinostheim, Germany).
  
  
  METHODS
  Fifty-one patients (76 eyes) were treated with a mean preoperative spherical equivalent refraction of -7.55 diopters (D) (range: -6.0 to -10.75 D). All eyes received a LASEK technique using 15% alcohol with a 20-second application.
  
  
  RESULTS
  An intact epithelial flap was obtained in 73 (96%) eyes. At 1 week, uncorrected visual acuity (UCVA) was > or =20/30 in 53 (70%) eyes and > or =20/60 in all eyes. At 6 months (n=76), the mean SE was +0.08 D (range: -1.00 to +1.875 D) with 73 (96%) eyes within +/-1.0 D of the intended correction and 60 (79%) eyes within +/-0.5 D. At 12 months (n=46), the mean SE was -0.07 D (range: -1.375 to +2.0 D) with 44 (96%) eyes within +/-1.0 D of the intended correction and 37 (80%) eyes within +/-0.5 D. Myopic cylindrical corrections were attempted in 68 eyes (range: -0.25 to -4.25 D) with vector analysis demonstrating a mean 85% correction. At last follow-up, UCVA was > or =20/20 in 47 (62%) eyes, > or =20/25 in 63 (83%) eyes, and > or =20/40 in 75 (99%) eyes. Three (4%) eyes gained two lines of Snellen decimal equivalent best spectacle-corrected visual acuity compared to preoperative levels, 68 (89%) eyes showed no change or gained one line, and 5 (7%) eyes lost one line. None lost more than one line. Only 2 (3%) eyes at 6 to 12 months had more than +1 axial corneal haze and 50 (66%) showed no evidence of haze on slit-lamp examination.
  
  
  CONCLUSIONS
  Laser subepithelial keratomileusis for myopia up to -11.00 D with the Schwind ESIRIS laser provides good refractive and visual outcomes, with acceptable visual recovery and minimal complications.
authors.affiliation: Department of Ophthalmology, St Thomas' Hospital, London, United Kingdom. davidobrart@aol.com
authors.forename: David P S
authors.initials: DP
authors.lastname: O'Brart
authors.forename: Mervat
authors.initials: M
authors.lastname: Al-Attar
authors.forename: Badril
authors.initials: B
authors.lastname: Hussein
authors.forename: Romesh
authors.initials: R
authors.lastname: Angunawela
authors.forename: John
authors.initials: J
authors.lastname: Marshall
mesh_terms: D000328:Adult; D019573:Epithelium, Corneal / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted / Q000295:instrumentation / Q000379:methods*; D007834:Lasers; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome