title: One-year outcomes of epi-LASIK for myopia.
abstract: OBJECTIVE
  To evaluate the early clinical outcomes of epi-LASIK for myopia.
  
  
  METHODS
  This study comprised 302 eyes of 162 patients. Epi-LASIK was performed with an automatically rotational epikeratome (KM-5000D). Epithelial separation was achieved mechanically without the use of alcohol. After laser ablation, the epithelial sheet was repositioned and a therapeutic contact lens was applied to the cornea immediately for 3 to 5 days. Postoperative visual acuity, symptoms, epithelial sheet, contrast sensitivity, wavefront aberration, and haze formation were evaluated 3, 6, and 12 months postoperatively.
  
  
  RESULTS
  Of the 302 eyes, 72 eyes (42 patients) with a mean spherical equivalent refraction of -9.13 +/- 4.23 diopters (D) (range: -1.25 to -19.0 D) had > 1-year follow-up. One eye failed to make the epithelial sheet because of the narrow palpebral fissure. An integrated epithelial sheet with a diameter of 8 to 9 mm was made in 289 (95.7%) eyes, leaving a superior hinge of approximately 2 to 4 mm. In 1 eye, stromal tissue remained in the epithelial sheet. Free epithelial flaps were made in 12 (4%) eyes. Mild discomfort was reported by 150 patients (282 eyes, 93.4%). Twelve patients (20 eyes, 6.6%) reported moderate symptoms. At 1 day postoperatively, corneal epithelium was almost transparent or had mild focal edema in 288 (95.4%) eyes; moderate edema was reported in 14 (4.6%) eyes. At 1 year postoperatively, spherical equivalent refraction of 60 (83.3%) eyes was within +/- 1.0 D of attempted refraction. Grade 0.5 haze was found in 2 eyes; all other eyes had no haze. No eye lost any lines of best spectacle-corrected visual acuity (BSCVA), whereas 12 (16.7%) of 72 eyes gained one or two lines of BSCVA. Contrast sensitivity decreased 1 month postoperatively and was restored to preoperative levels in eyes with preoperative spherical equivalent refraction < -10.0 D. Higher order aberration increased significantly postoperatively.
  
  
  CONCLUSIONS
  Epi-LASIK is a safe and efficient method to correct myopia with the advantage that it has only mild symptoms and mild haze. A larger study with longer follow-up is needed to determine its long-term clinical outcomes.
authors.affiliation: Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.
authors.forename: Jinhui
authors.initials: J
authors.lastname: Dai
authors.forename: Renyuan
authors.initials: R
authors.lastname: Chu
authors.forename: Xingtao
authors.initials: X
authors.lastname: Zhou
authors.forename: Chongda
authors.initials: C
authors.lastname: Chen
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Qu
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Wang
mesh_terms: D000328:Adult; D003318:Corneal Opacity / Q000209:etiology / Q000473:pathology; D019573:Epithelium, Corneal / Q000473:pathology; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012029:Refraction, Ocular; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity