Laser in situ keratomileusis versus surface ablation: visual outcomes and complications.
OBJECTIVE
To compare the visual outcomes and complications of laser in situ keratomileusis (LASIK) with those of surface treatment by laser-assisted subepithelial keratectomy (LASEK), photorefractive keratectomy with mechanical epithelial removal (M-PRK), and transepithelial photorefractive keratectomy (T-PRK).


METHODS
Tertiary care eye center.


METHODS
This retrospective review comprised all cases of LASIK, LASEK, M-PRK, and T-PRK performed at King Khaled Eye Specialist Hospital between July 1, 2004, and June 30, 2005. Separate statistical analyses were performed for eyes with low to moderate myopia (spherical equivalent [SE] less than -6.00 diopters [D]) and high myopia (SE -6.00 to -11.25 D).


RESULTS
Of 696 eyes that met the inclusion criteria, 464 had LASIK, 104 had LASEK, 69 had M-PRK, and 59 had T-PRK. Eyes with low to moderate myopia had a statistically significantly smaller mean difference between logMAR final postoperative uncorrected visual acuity (UCVA) and preoperative best spectacle-corrected visual acuity (BSCVA) after T-PRK and M-PRK than after LASIK or LASEK. A higher percentage of eyes with high myopia had a final UCVA within +/-2 lines of the preoperative BSCVA with T-PRK than with LASIK, LASEK, or M-PRK. There were more major non-flap-related complications after LASEK than after LASIK, M-PRK, or T-PRK.


CONCLUSIONS
In eyes with low to moderate myopia, T-PRK and M-PRK provided slightly better visual outcomes than LASIK or LASEK. In eyes with high myopia, T-PRK provided better visual outcomes than LASIK, LASEK, and M-PRK. Laser in situ keratomileusis was associated with the most major postoperative complications.
Ghadhfan
Faisal
F
Anterior Segment Division, Department of Ophthalmology, Research Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia. drfaisal@doctors.org.uk
Al-Rajhi
Ali
A
Wagoner
Michael D
MD
D000293:Adolescent; D000328:Adult; D000368:Aged; D003315:Cornea / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D049008:Keratectomy, Subepithelial, Laser-Assisted / Q000379:methods*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery; D018903:Photorefractive Keratectomy / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology*