title: Subjective pain, visual recovery and visual quality after LASIK, EpiLASIK (flap off) and APRK - a consecutive, non-randomized study.
abstract: BACKGROUND
  Laser in situ keratomileusis (LASIK) is superior to surface ablation techniques (SAT) such as alcohol photorefractive keratectomy (APRK) or Epi-LASIK (EpiK) in terms of visual recovery and postoperative pain. This study compares subjective symptoms and visual recovery of two different SATs with LASIK.
  
  
  METHODS
  One hundred and twenty seven patients were operated using one of the three techniques. Patients filled out a questionnaire describing symptoms assessing subjective visual recovery on a linear scale from 'not functioning' to 'full visual function' and pain on a linear scale from 'no pain' to 'severe daily pain'. Subjective symptoms such as halos, double vision, low night vision, reduced contrast and dry eyes were also evaluated.
  
  
  RESULTS
  Visual recovery was faster and discomfort symptoms less pronounced with the LASIK than with surface ablation procedures. More pain was reported after APRK than after EpiK (flap-off technique) in the early postoperative period, with a maximum of pain on postoperative days 3-4. Subjective visual recovery showed no statistically significant difference between the two surface ablation procedures. Halos, double vision, low night vision, reduced contrast and dry eyes were more extensively reported by the EpiK than the APRK group and were less pronounced in the LASIK than in the SAT group.
  
  
  CONCLUSIONS
  Our study does not uniformly support the previously published favourable results of EpiK compared to APRK with regard to subjective recovery of vision and postoperative pain.
authors.affiliation: Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany. skevaschris@gmx.de
authors.forename: Christos
authors.initials: C
authors.lastname: Skevas
authors.forename: Toam
authors.initials: T
authors.lastname: Katz
authors.forename: Lars
authors.initials: L
authors.lastname: Wagenfeld
authors.forename: Gisbert
authors.initials: G
authors.lastname: Richard
authors.forename: Stephan
authors.initials: S
authors.lastname: Linke
mesh_terms: D058447:Eye Pain / Q000175:diagnosis*; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted / Q000379:methods*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D009216:Myopia / Q000601:surgery; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis*; D018903:Photorefractive Keratectomy / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology*; D012029:Refraction, Ocular; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*