title: Clinical outcomes of epi-LASIK: 1-year results of on- and off-flap procedures with and without mitomycin-C.
abstract: AIM To evaluate and compare the clinical outcomes of epi-laser in situ keratomileusis (LASIK) performed either on-flap or off-flap with or without 0.02% mitomycin-C (MMC) in terms of corneal haziness, pain scores and satisfaction scores. METHODS In this non-randomised comparative retrospective study, the charts of 198 patients (394 eyes) who had undergone an epi-LASIK procedure for myopia (-1.5 D to -8.0 D spherical equivalent) correction were reviewed. Patients were classified into four groups: Group I, on-flap without MMC, 181 eyes; Group II, on-flap with MMC, 52 eyes; Group III, off-flap without MMC, 93 eyes; Group IV, off-flap with MMC, 68 eyes. We compared the group outcomes on the first day, 1, 3 and 6 months and 1 year after the operation. RESULTS The mean uncorrected visual acuity was significantly better in the off-flap groups (III and IV) than in the on-flap groups (I and II) on day 1 (p=0.002). There was no significant difference in the spherical equivalent among all groups at 1 year (p=0.305). Some degree of haziness was present in 10 eyes (Grade II: 2; Grade I: 8), but the haziness level was not significantly different among groups at 1 year (p=0.533). Pain scores (0-10) were lower in the off-flap groups (III and IV) (p=0.010). Satisfaction scores (0-10) were higher in the off-flap groups (III and IV), but the difference was not statistically significant (p=0.248). CONCLUSIONS Myopic correction by epi-LASIK surgery with all four methods showed stable visual results in terms of the 1-year postoperative clinical outcomes. Haziness levels revealed that treatment with 0.02% MMC was less effective than expected. Overall, the off-flap method offered faster visual recovery and less postoperative pain than the on-flap method.
authors: Department of Ophthalmology, Chosun University College of Medicine, #588 Seoseok-dong, Dong-gu, Gwangju, 501-140, Republic of Korea.
authors: Seong Taeck
authors: ST
authors: Kim
authors: Jae Woong
authors: JW
authors: Koh
authors: Gil Joong
authors: GJ
authors: Yoon
authors: Seong Won
authors: SW
authors: Yang
mesh_terms: D000328:Adult; D003318:Corneal Opacity / Q000209:etiology / Q000517:prevention & control; D019781:Corneal Topography; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects / Q000379:methods*; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin