A prospective, contralateral eye study comparing thin-flap LASIK (sub-Bowman keratomileusis) with photorefractive keratectomy.
OBJECTIVE
To determine the differences in the visual results, pain response, biomechanical effect, quality of vision, and higher-order aberrations, among other parameters, in eyes undergoing either photorefractive keratectomy (PRK) or thin-flap LASIK/sub-Bowman keratomileusis (SBK; intended flap thickness of +/-100 microm and 8.5-mm diameter) at 1, 3, and 6 months after surgery.


METHODS
A contralateral eye pilot study.


METHODS
Fifty patients (100 eyes) were enrolled at 2 sites.


METHODS
The mean preoperative spherical refraction was -3.66 diopters (D) and the mean cylinder was -0.66 D for all eyes. Eyes in the PRK group underwent 8.5-mm ethanol-assisted PRK, whereas in eyes in the SBK group, an 8.5-mm, (intended) 100-microm flap was created with a 60-kHz IntraLase femtosecond laser (Advanced Medical Optics, Santa Ana, CA). All eyes underwent a customized laser ablation using an Alcon LADARVision 4000 CustomCornea excimer laser (Alcon Laboratories, Fort Worth, TX).


METHODS
Preoperative and postoperative tests included best spectacle-corrected visual acuity, uncorrected visual acuity (UCVA), corneal topography, wavefront aberrometry, retinal image quality, and contrast sensitivity. Patients completed subjective questionnaires at each visit.


RESULTS
One- and 3-month UCVA results showed a statistically significant difference: SBK, 88% 20/20 or better vs. 48% 20/20 or better for PRK. At 6 months, UCVA was 94% 20/20 or better for PRK and 92% for SBK. At 1 and 3 months, the SBK group had lower higher-order aberrations (coma and spherical aberration; P<or=0.05); at 1, 3, and 6 months, there was no statistically significant difference in spherical aberration and vertical and horizontal coma between the 2 groups.


CONCLUSIONS
At the 1-month follow-up, the thin-flap/SBK group demonstrated clinically and statistically significant better visual acuity than the PRK group. By 3 months, the vision in the 2 groups had begun to equalize, although the SBK eyes continued to have better vision. At 6 months, there were no statistical differences between the 2 groups.


BACKGROUND
Proprietary or commercial disclosure may be found after the references.
Slade
Stephen G
SG
The Slade & Baker Vision Institute, Houston, TX 77027, USA. sgs@visiontexas.com
Durrie
Daniel S
DS
Binder
Perry S
PS
D000328:Adult; D015350:Contrast Sensitivity / Q000502:physiology; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D010149:Postoperative Pain; D018903:Photorefractive Keratectomy / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult