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.
Anterior Segment Division, Department of Ophthalmology, Research Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia. drfaisal@doctors.org.uk
Faisal
F
Ghadhfan
Ali
A
Al-Rajhi
Michael D
MD
Wagoner
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*