Bilateral comparison of conventional epithelial laser in situ keratomileusis and lamellar epithelial debridement for moderate to high myopia.
OBJECTIVE
To compare early postoperative pain and visual outcomes after conventional epithelial laser in situ keratomileusis and lamellar epithelial debridement (LED) procedures used to treat myopia.


METHODS
Prospective bilateral comparison between conventional epithelial laser in situ keratomileusis, in which the epithelial flap was repositioned, and LED, in which the epithelial sheet was removed, was designed. Eighteen patients were included. The Amadeus II Epi-Keratome (Advanced Medical Optics, Santa Ana, CA) and the Zywave Z100 instrument (Bausch & Lomb, Rochester, NY) were used in both groups. Therapeutic contact lenses (Focus 1-2 Week; CIBA Vision, Duluth, GA) were applied. To control postoperative pain, Durogesic D-trans patches 12 mug/h (Janssen Pharmaceutica, Piscataway, NJ) were prescribed. During the early postoperative period, pain, uncorrected visual acuity (UCVA), and time of epithelial healing were recorded. Late visual outcomes including UCVA and corneal haze were examined during follow-up over 6 months.


RESULTS
The pain score at the fourth postoperative day was significantly lower in the LED group compared with the conventional group (P < 0.05). The UCVA in the LED group was significantly better than that in the conventional group during the early postoperative period. Mean epithelial healing time was significantly longer in the conventional group (5.33 +/- 2.03 days) than that in the LED group (3.56 +/- 0.86 days). There was no between-group difference in corneal haze development or UCVA during the 6-month follow-up period.


CONCLUSIONS
Patients in the LED group experienced less postoperative pain, faster corneal healing, and quicker visual recovery during the early postoperative period, compared with those the conventional group.
Kim
Jae-Hyung
JH
Department of Ophthalmology, University of Ulsan College of Medicine, Seoul, Korea.
Lim
Taehyung
T
Lee
Hee Gyung
HG
Kim
Jae Yong
JY
Kim
Myoung Joon
MJ
Tchah
Hungwon
H
D000328:Adult; D003646:Debridement / Q000379:methods*; D019573:Epithelium, Corneal / Q000601:surgery*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D047728:Myopia, Degenerative / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis; D011446:Prospective Studies; D013524:Surgical Flaps; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult